MEDICARE: MR. SCOTT CRILL DENLINGER 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	RT004152	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1004524	OTHER	PA	NATA

General Provider Information

NPI Number	:	1619145992
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. SCOTT CRILL DENLINGER ATC

Provider Business Mailing Address
First Line	:	UPMC SPORTS MEDICINE
Second Line	:	3200 SOUTH WATER ST.
City	:	PITTSBURGH
State	:	PA
Zip	:	15203
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	SOUTH ALLEGHENY HIGH SCHOOL
Second Line	:	2743 WASHINGTON BLVD.
City	:	MCKEESPORT
State	:	PA
Zip	:	15133
Country	:	US
Telephone Number	:	412-675-3070
Fax Number	:

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

Provider Enumeration Date	:	02/20/2008
Last Update Date	:	02/20/2008

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