Alicia Tock

Individual provider Active NPI Athletic Trainer · Hamilton, MI

NPI 1013319920 · NPPES record last updated Sep 23, 2014

Key facts

NPI
1013319920
Entity type
Individual (NPI type 1)
Primary specialty
Athletic Trainer 2255A2300X
License
2601000328 (MI)
Practice address
3491 Lincoln Rd
Hamilton, MI 49419-9512
Phone
(269) 751-2150
NPI assigned
Sep 23, 2014
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
2601000328MIMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
West Michigan Rehabilitation PC Past
since Dec 15, 2007
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 2601000328 MI Yes

Addresses

Primary practice location

3491 Lincoln Rd
Hamilton, MI 49419-9512

Mailing address

PO Box 1695
Holland, MI 49422-1695
Phone (616) 392-3197

Other providers in Hamilton, MI

All providers in Hamilton, MI · Athletic Trainer in Michigan

Sources for this page

Verify at the official NPI Registry.