Provider Demographics
NPI:1417204421
Name:BEDOYA, ABIGAIL A (ATC,LAT)
Entity type:Individual
Prefix:MRS
First Name:ABIGAIL
Middle Name:A
Last Name:BEDOYA
Suffix:
Gender:F
Credentials:ATC,LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1136 MARFIELD DR
Mailing Address - Street 2:
Mailing Address - City:NAZARETH
Mailing Address - State:PA
Mailing Address - Zip Code:18064-9595
Mailing Address - Country:US
Mailing Address - Phone:610-751-5734
Mailing Address - Fax:
Practice Address - Street 1:1136 MARFIELD DR
Practice Address - Street 2:
Practice Address - City:NAZARETH
Practice Address - State:PA
Practice Address - Zip Code:18064-9595
Practice Address - Country:US
Practice Address - Phone:610-751-5734
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-08
Last Update Date:2014-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PART0051962255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer