MEDICARE: JENNIFER STRICKLER ATC, PHD, MS, ASPS

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	1102	OK

General Provider Information

NPI Number	:	1578278156
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER STRICKLER ATC, PHD, MS, ASPS

Provider Business Mailing Address
First Line	:	9600 N OKLAHOMA AVE
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73114-7404
Country	:	US
Telephone Number	:	618-559-6553
Fax Number	:

Provider Business Practice Location Address
First Line	:	9600 N OKLAHOMA AVE
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73114-7404
Country	:	US
Telephone Number	:	618-559-6553
Fax Number	:

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

Provider Enumeration Date	:	01/18/2023
Last Update Date	:	01/18/2023

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