Bacon, Andrew Michael

Bacon, Andrew Michael is an individual health care provider with primary practice located at 300 College Park Cronin Athletic Center Room 101 , Dayton OH 45469-0001. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Bacon, Andrew Michael can be contacted via phone (951) 541-4697.

Contact Information

Primary practice address
300 College Park Cronin Athletic Center Room 101 Dayton OH 45469-0001
Phone: (951) 541-4697
Fax: (937) 229-5448
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 004263 Ohio

Profile Details

NPI number 1801219548
LBN Legal business name Bacon, Andrew Michael
Credentials MS, AT, ATC
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 31st, 2014
Last updated Jan 5th, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1801219548 NPPES
Other 2000007147 NATIONAL ATHLETIC TRAINERS' ASSOCIATION BOARD OF CERTIFIACTION

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