Provider Demographics
NPI:1134659592
Name:SYROTCHEN, VICTORIA (BS, ATC, LAT)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:
Last Name:SYROTCHEN
Suffix:
Gender:F
Credentials:BS, ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2002 E PARK AVE APT 31
Mailing Address - Street 2:
Mailing Address - City:SEARCY
Mailing Address - State:AR
Mailing Address - Zip Code:72143-5721
Mailing Address - Country:US
Mailing Address - Phone:636-866-8575
Mailing Address - Fax:
Practice Address - Street 1:915 E MARKET AVE
Practice Address - Street 2:
Practice Address - City:SEARCY
Practice Address - State:AR
Practice Address - Zip Code:72149-5721
Practice Address - Country:US
Practice Address - Phone:501-279-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-18
Last Update Date:2017-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer