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NPI Code Detail

MEDICARE: MRS. DENISE A BICKETT ATC

MEDICARE: MRS. DENISE A BICKETT 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
12255A2300XAthletic Trainer

General Provider Information

NPI Number : 1699724716
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. DENISE A BICKETT ATC
Provider Business Mailing Address
First Line : 590 GRANGE HALL RD
Second Line :
City : ORTONVILLE
State : MI
Zip : 48462-8882
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 328 EAST ST
Second Line :
City : ROCHESTER
State : MI
Zip : 48307-2013
Country : US
Telephone Number : 248-651-8085
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/08/2006
Last Update Date : 07/08/2007

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Directions to “ MRS. DENISE A BICKETT ATC” Practice Location

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