Taylor L Walendzik, ATC, AT
Individual provider Active NPI Athletic Trainer · Belmont, MI
NPI 1164061826 · NPPES record last updated Dec 29, 2019
Key facts
- NPI
- 1164061826
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Athletic Trainer 2255A2300X
- License
- 2601002338 (MI)
- Practice address
- 2464 Bridle Way NE
Belmont, MI 49306-7810 - Phone
- (616) 540-3612
- NPI assigned
- Dec 29, 2019
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2601002338 | MI | MD | Athletic Trainer |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 2601002338 | MI | Yes |
Addresses
Primary practice location
2464 Bridle Way NE
Belmont, MI 49306-7810
Mailing address
2464 Bridle Way NE
Belmont, MI 49306-7810
Phone (616) 540-3612
Other providers in Belmont, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 29, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.