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NPI Code Detail

MEDICARE: MS. DAISY MARIE KOVACH M.S., ATC

MEDICARE:  MS. DAISY MARIE KOVACH  M.S., 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 : 1760405385
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. DAISY MARIE KOVACH M.S., ATC
Provider Business Mailing Address
First Line : 1141 BRIDFORD LAKE CIR APT P
Second Line :
City : GREENSBORO
State : NC
Zip : 27407-5172
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 900 SPRING GARDEN ST
Second Line : 136 HHP BUILDING, UNCG ATHLETICS
City : GREENSBORO
State : NC
Zip : 27403-2410
Country : US
Telephone Number : 336-334-5925
Fax Number : 336-256-0407
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/25/2006
Last Update Date : 07/08/2007

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Directions to “ MS. DAISY MARIE KOVACH M.S., ATC” Practice Location

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