MEDICARE: MR. JAMES WARREN OCHSE ATC, CSCS,D, NSCA-C

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	RT001722A	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	22	OTHER	PA	CERT. ATHLETIC TRAINER

General Provider Information

NPI Number	:	1639134547
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JAMES WARREN OCHSE ATC, CSCS,D, NSCA-C

Provider Business Mailing Address
First Line	:	1525 CHURCH RD
Second Line	:
City	:	ALLENTOWN
State	:	PA
Zip	:	18103-8334
Country	:	US
Telephone Number	:	610-798-0353
Fax Number	:

Provider Business Practice Location Address
First Line	:	DESALES UNIVERSITY
Second Line	:	2755 STATION AVE.
City	:	CENTER VALLEY
State	:	PA
Zip	:	18034-9668
Country	:	US
Telephone Number	:	610-282-1100
Fax Number	:

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

Provider Enumeration Date	:	04/20/2006
Last Update Date	:	09/06/2023

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