MEDICARE: MS. KATIE MARIE SVIHLIK MS, 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	AT.003112	OH

General Provider Information

NPI Number	:	1538470836
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KATIE MARIE SVIHLIK MS, ATC/LAT

Provider Business Mailing Address
First Line	:	3800 VICTORY PKWY
Second Line	:	ML 7530
City	:	CINCINNATI
State	:	OH
Zip	:	45207-1035
Country	:	US
Telephone Number	:	513-745-4274
Fax Number	:	513-745-1963

Provider Business Practice Location Address
First Line	:	3800 VICTORY PKWY
Second Line	:	ML 7530
City	:	CINCINNATI
State	:	OH
Zip	:	45207-1035
Country	:	US
Telephone Number	:	513-745-4274
Fax Number	:	513-745-1963

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

Provider Enumeration Date	:	07/01/2010
Last Update Date	:	04/11/2012

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