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NPI Code Detail

MEDICARE: JEFFREY JAMES PIPER ATC

MEDICARE:   JEFFREY JAMES PIPER  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 Trainer003114NY

General Provider Information

NPI Number : 1881107654
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEFFREY JAMES PIPER ATC
Provider Business Mailing Address
First Line : 115 OLD ORCHARD LN
Second Line :
City : BALLSTON SPA
State : NY
Zip : 12020-3733
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 43 SPRING ST
Second Line :
City : SCHUYLERVILLE
State : NY
Zip : 12871-1014
Country : US
Telephone Number : 518-507-6414
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/14/2017
Last Update Date : 11/14/2017

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Directions to “ JEFFREY JAMES PIPER ATC” Practice Location

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