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NPI Code Detail

MEDICARE: KATHERINE ANNA PERLSWEIG MS, ATC, LAT, CSCS

MEDICARE:   KATHERINE ANNA PERLSWEIG  MS, ATC, LAT, CSCS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12255A2300XAthletic TrainerAL3045FL

General Provider Information

NPI Number : 1346260593
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHERINE ANNA PERLSWEIG MS, ATC, LAT, CSCS
Provider Business Mailing Address
First Line : 2000 TRIDENT WAY
Second Line : BLDG 624
City : SAN DIEGO
State : CA
Zip : 92155-5493
Country : US
Telephone Number : 619-437-1404
Fax Number :
Provider Business Practice Location Address
First Line : 2000 TRIDENT WAY
Second Line : BLDG 624
City : SAN DIEGO
State : CA
Zip : 92155-5493
Country : US
Telephone Number : 619-437-1404
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/20/2006
Last Update Date : 07/11/2015

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Directions to “ KATHERINE ANNA PERLSWEIG MS, ATC, LAT, CSCS” Practice Location

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