MEDICARE: MR. GREG W SEIER 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	2255A2300X	Athletic Trainer	350	NE

General Provider Information

NPI Number	:	1508831736
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. GREG W SEIER ATC

Provider Business Mailing Address
First Line	:	1305 W 7TH ST
Second Line	:
City	:	WAYNE
State	:	NE
Zip	:	68787-1694
Country	:	US
Telephone Number	:	712-574-4648
Fax Number	:

Provider Business Practice Location Address
First Line	:	1111 MAIN ST
Second Line	:
City	:	WAYNE
State	:	NE
Zip	:	68787-1181
Country	:	US
Telephone Number	:	402-375-7582
Fax Number	:

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

Provider Enumeration Date	:	02/21/2006
Last Update Date	:	07/08/2007

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