MEDICARE: SARAH MARIE AROCHA ATC, LAT

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
1	2255A2300X	Athletic Trainer	AT5083	TX

General Provider Information

NPI Number	:	1417457037
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH MARIE AROCHA ATC, LAT

Provider Business Mailing Address
First Line	:	2340 MOUNT CARMEL DR
Second Line	:
City	:	WACO
State	:	TX
Zip	:	76710-1504
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1111 HERRING AVE
Second Line	:
City	:	WACO
State	:	TX
Zip	:	76708-3642
Country	:	US
Telephone Number	:	254-750-1346
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/20/2018
Last Update Date	:	02/20/2018

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