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NPI Code Detail

MEDICARE: MRS. BOBBI A. SEVERT ATC

MEDICARE: MRS. BOBBI A. SEVERT ATC
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 Trainer585TN

General Provider Information

NPI Number : 1376592774
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. BOBBI A. SEVERT ATC
Provider Business Mailing Address
First Line : 8258 HICKORY VALLEY RD
Second Line :
City : SPARTA
State : TN
Zip : 38583-4036
Country : US
Telephone Number : 931-738-7915
Fax Number :
Provider Business Practice Location Address
First Line : 1120 SAMS ST
Second Line :
City : COOKEVILLE
State : TN
Zip : 38506-4006
Country : US
Telephone Number : 931-528-7312
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/10/2006
Last Update Date : 07/01/2009

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Directions to “ MRS. BOBBI A. SEVERT ATC” Practice Location

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