Justin Tyler Luke
Individual provider Active NPI Athletic Trainer · Bexley, OH
NPI 1154041044 · NPPES record last updated Aug 31, 2022
Key facts
- NPI
- 1154041044
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Athletic Trainer 2255A2300X
- Practice address
- 1 College and Main
Bexley, OH 43209-7812 - Phone
- (614) 236-6700
- NPI assigned
- Aug 31, 2022
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | Yes |
Addresses
Primary practice location
1 College and Main
Bexley, OH 43209-7812
Mailing address
6149 Crestlawn Dr SE
East Canton, OH 44730-9553
Other providers in Bexley, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 31, 2022. 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.