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NPI Code Detail

MEDICARE: SARAH MARIE EICHACKER ATC

MEDICARE: SARAH MARIE EICHACKER 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 Trainer467SD

General Provider Information

NPI Number : 1497357610
Entity Type Code : Individual
Provider Name (Legal Business Name) : SARAH MARIE EICHACKER ATC
Provider Business Mailing Address
First Line : 7721 W SNAPDRAGON ST UNIT 3
Second Line :
City : SIOUX FALLS
State : SD
Zip : 57106-5172
Country : US
Telephone Number : 605-212-0304
Fax Number :
Provider Business Practice Location Address
First Line : 6800 S LOUISE AVE
Second Line :
City : SIOUX FALLS
State : SD
Zip : 57108-6026
Country : US
Telephone Number : 605-212-0304
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/12/2020
Last Update Date : 11/12/2020

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Directions to “ SARAH MARIE EICHACKER ATC” Practice Location

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