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Individual

MISS REBECCA J BADACH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
55 CARLTON ST, UGA, UNIVERISTY HEALTH CENTER, ATHENS, GA 30602-1755
(706) 542-8636
(706) 542-0214
Mailing address
55 CARLTON ST, UGA, UNIVERISTY HEALTH CENTER, ATHENS, GA 30602-1755
(706) 542-8636
(706) 542-0214

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
363A00000X
Physician Assistant
Primary
004713
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
30332876
NH
Enumeration date
03/13/2008
Last updated
10/09/2009
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