MEDICARE: MATTHEW DRESCHER 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
1	146N00000X	Basic Emergency Medical Technician	SC038546	SC
2	2255A2300X	Athletic Trainer

General Provider Information

NPI Number	:	1457888273
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MATTHEW DRESCHER ATC

Provider Business Mailing Address
First Line	:	732 RAVENGLASS DR
Second Line	:
City	:	FORT MILL
State	:	SC
Zip	:	29715-7326
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	732 RAVENGLASS DR
Second Line	:
City	:	FORT MILL
State	:	SC
Zip	:	29715-7326
Country	:	US
Telephone Number	:	803-325-5202
Fax Number	:

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

Provider Enumeration Date	:	05/11/2017
Last Update Date	:	05/11/2017

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