MEDICARE: ALLISON TRACY BATES

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	222Q00000X	Developmental Therapist

General Provider Information

NPI Number	:	1942451026
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALLISON TRACY BATES

Provider Business Mailing Address
First Line	:	PO BOX 7251
Second Line	:
City	:	SEBRING
State	:	FL
Zip	:	33872-0105
Country	:	US
Telephone Number	:	863-446-2594
Fax Number	:

Provider Business Practice Location Address
First Line	:	10415 US HIGHWAY 98
Second Line	:
City	:	SEBRING
State	:	FL
Zip	:	33876-9592
Country	:	US
Telephone Number	:	863-446-2594
Fax Number	:

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

Provider Enumeration Date	:	10/07/2008
Last Update Date	:	10/07/2008

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