Individual
ANDREW MICHAEL BACON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, AT, ATC
Contact information
Practice address
300 COLLEGE PARK CRONIN ATHLETIC CENTER ROOM 101, DAYTON, OH 45469-0001
(951) 541-4697
(937) 229-5448
Mailing address
300 COLLEGE PARK CRONIN ATHLETIC CENTER ROOM 101, DAYTON, OH 45469-0001
(951) 541-4697
(937) 229-5448
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
004263
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2000007147
NATIONAL ATHLETIC TRAINERS' ASSOCIATION BOARD OF CERTIFIACTION
—
Enumeration date
01/31/2014
Last updated
01/05/2022
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