MEDICARE: MISS ERIN KIMBERLY FINNEGAN 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

General Provider Information

NPI Number	:	1790757235
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS ERIN KIMBERLY FINNEGAN ATC

Provider Business Mailing Address
First Line	:	48 COLLINS AVE
Second Line	:
City	:	WEST SENECA
State	:	NY
Zip	:	14224-1131
Country	:	US
Telephone Number	:	716-435-4434
Fax Number	:

Provider Business Practice Location Address
First Line	:	OHIO UNIVERSTIY
Second Line	:	GROVER CENTER E207
City	:	ATHENS
State	:	OH
Zip	:	45701-2979
Country	:	US
Telephone Number	:	740-593-0322
Fax Number	:

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

Provider Enumeration Date	:	02/07/2006
Last Update Date	:	07/08/2007

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