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NPI Code Detail

MEDICARE: MADELINE SVEC

MEDICARE: MADELINE SVEC
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 Trainer
2390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1992198014
Entity Type Code : Individual
Provider Name (Legal Business Name) : MADELINE SVEC
Provider Business Mailing Address
First Line : 3170 ESTATES DR N
Second Line :
City : SAINT JOSEPH
State : MI
Zip : 49085-3435
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3170 ESTATES DR N
Second Line :
City : SAINT JOSEPH
State : MI
Zip : 49085-3435
Country : US
Telephone Number : 269-449-7780
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/13/2015
Last Update Date : 03/13/2015

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Directions to “ MADELINE SVEC ” Practice Location

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