Cory Andrews, A.T.C. L.A.T.
Individual provider Active NPI Athletic Trainer · Warsaw, IN
NPI 1043366263 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1043366263
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Athletic Trainer 2255A2300X
- License
- 36001293A (IN)
- Practice address
- 2101 Dubois Dr
Warsaw, IN 46580-3210 - Phone
- (574) 372-7671
- Fax
- (574) 372-7625
- NPI assigned
- Jan 29, 2007
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 36001293A | IN | MD | Athletic Trainer |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 36001293A | IN | Yes |
Addresses
Primary practice location
2101 Dubois Dr
Warsaw, IN 46580-3210
Mailing address
1906 N Sandpiper Dr
Apt B
Warsaw, IN 46582-9021
Phone (239) 405-3059
Other providers in Warsaw, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.