MEDICARE: MICHAEL SPRIGGS 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	AT.003653	OH

General Provider Information

NPI Number	:	1669885844
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL SPRIGGS ATC

Provider Business Mailing Address
First Line	:	2123 STILLMAN RD
Second Line	:
City	:	CLEVELAND HEIGHTS
State	:	OH
Zip	:	44118-2720
Country	:	US
Telephone Number	:	216-687-4806
Fax Number	:	216-687-9267

Provider Business Practice Location Address
First Line	:	2121 EUCLID AVE
Second Line	:	PE BLDG - SB6
City	:	CLEVELAND
State	:	OH
Zip	:	44115-2214
Country	:	US
Telephone Number	:	216-687-4806
Fax Number	:	216-687-9267

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

Provider Enumeration Date	:	06/05/2014
Last Update Date	:	06/05/2014

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