Provider Demographics
NPI:1023296522
Name:ZARGER, MIKE LEE (ATC/L)
Entity type:Individual
Prefix:MR
First Name:MIKE
Middle Name:LEE
Last Name:ZARGER
Suffix:
Gender:M
Credentials:ATC/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2300 JENKS AVE
Mailing Address - Street 2:SUITE C
Mailing Address - City:LYNN HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:32444-4798
Mailing Address - Country:US
Mailing Address - Phone:850-248-1600
Mailing Address - Fax:850-248-1602
Practice Address - Street 1:2300 JENKS AVE
Practice Address - Street 2:SUITE C
Practice Address - City:LYNN HAVEN
Practice Address - State:FL
Practice Address - Zip Code:32444-4798
Practice Address - Country:US
Practice Address - Phone:850-248-1600
Practice Address - Fax:850-248-1602
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-06
Last Update Date:2008-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL3172255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer