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NPI Code Detail

MEDICARE: JESSICA MORIAH COVERT ATC

MEDICARE: JESSICA MORIAH COVERT 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 TrainerAT002093GA
22255A2300XAthletic Trainer1550TN

General Provider Information

NPI Number : 1932455342
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA MORIAH COVERT ATC
Provider Business Mailing Address
First Line : 1200 CORPORATE DR STE 400
Second Line :
City : BIRMINGHAM
State : AL
Zip : 35242-5424
Country : US
Telephone Number : 423-238-7217
Fax Number : 423-238-3473
Provider Business Practice Location Address
First Line : 3575 KEITH ST NW
Second Line : STE 205
City : CLEVELAND
State : TN
Zip : 37312-4324
Country : US
Telephone Number : 423-559-0444
Fax Number : 423-559-0103
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/03/2012
Last Update Date : 01/18/2019

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Directions to “ JESSICA MORIAH COVERT ATC” Practice Location

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