MEDICARE: MRS. LAURIE S. ZAPARZYNSKI 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	RT000427A	PA

General Provider Information

NPI Number	:	1811969439
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LAURIE S. ZAPARZYNSKI ATC

Provider Business Mailing Address
First Line	:	75 BROOKLYN ST
Second Line	:
City	:	MANSFIELD
State	:	PA
Zip	:	16933-9708
Country	:	US
Telephone Number	:	570-662-4467
Fax Number	:	570-662-4465

Provider Business Practice Location Address
First Line	:	DECKER GYMANSIUM-STADIUM DR.
Second Line	:	MANSFIELD UNIVERSITY
City	:	MANSFIELD
State	:	PA
Zip	:	16933
Country	:	US
Telephone Number	:	570-662-4467
Fax Number	:	570-662-4465

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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