Adam Raikes, ATC
Specialist/Technologist, Athletic Trainer in Logan, UT. Individual provider (NPI-1).
NPI number1285961565
StatusActive
Last updated in NPPESMay 4, 2015
Details
- NPI
- 1285961565
- Entity type
- Individual (NPI-1)
- Name
- Adam Raikes
- Credential
- ATC
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Nov 7, 2009
- Last updated
- May 4, 2015
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2255A2300X | Specialist/Technologist, Athletic Trainer | 7415969-4810 | UT | Yes |
Practice location
7000 Old Main HlLogan, UT 84322-7000
Phone 520-271-9538 · Fax 520-271-9538
Mailing address
7000 Old Main HlLogan, UT 84322-7000
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