MEDICARE: MR. ADAM J. ZURICK 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	RT001275A	PA

General Provider Information

NPI Number	:	1861428807
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ADAM J. ZURICK ATC

Provider Business Mailing Address
First Line	:	5 COLONY RD
Second Line	:
City	:	MYERSTOWN
State	:	PA
Zip	:	17067-1728
Country	:	US
Telephone Number	:	717-866-7051
Fax Number	:	717-866-9265

Provider Business Practice Location Address
First Line	:	180 ELCO DR
Second Line	:
City	:	MYERSTOWN
State	:	PA
Zip	:	17067-2604
Country	:	US
Telephone Number	:	717-866-7447
Fax Number	:	717-866-9265

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

Provider Enumeration Date	:	06/23/2006
Last Update Date	:	07/08/2007

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