Vanessa Rusin, ATC

Individual provider Active NPI Athletic Trainer · Simpson, PA

NPI 1154556629 · NPPES record last updated May 27, 2009

Key facts

NPI
1154556629
Entity type
Individual (NPI type 1)
Primary specialty
Athletic Trainer 2255A2300X
License
RT004536 (PA)
Practice address
126 Jefferson St
Simpson, PA 18407-1210
Phone
(570) 575-4724
NPI assigned
May 27, 2009
Sex
Female
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

LicenseStateTypeSpecialty
RT004536PAMDAthletic Trainer

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X RT004536 PA Yes

Addresses

Primary practice location

126 Jefferson St
Simpson, PA 18407-1210

Mailing address

126 Jefferson St
Simpson, PA 18407-1210
Phone (570) 575-4724

Other providers in Simpson, PA

All providers in Simpson, PA · Athletic Trainer in Pennsylvania

Sources for this page

Verify at the official NPI Registry.