Purdue University Sports Medicine West Lafayette

Organization Active NPI Registered Dietitian · West Lafayette, IN

NPI 1154797371 · NPPES record last updated Aug 12, 2015

Key facts

NPI
1154797371
Entity type
Organization (NPI type 2)
Primary specialty
Registered Dietitian 133V00000X
Legal business name
PURDUE UNIVERSITY SPORTS MEDICINE WEST LAFAYETTE
Practice address
900 N John R Wooden Dr
West Lafayette, IN 47907-2117
Phone
(765) 650-0727
NPI assigned
Aug 12, 2015
Organization subpart
No

Authorized official

Name
Mrs. Jessica Lipsett, AT, DPT
Title
Assoc. Director of Sports Medicine
Phone
(765) 494-3245

Corporate family (same tax ID) 18

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
Purdue University Sports Medicine West Lafayette (19 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian
Group: 193200000X MULTI-SPECIALTY GROUP
133V00000X Yes

Addresses

Primary practice location

900 N John R Wooden Dr
West Lafayette, IN 47907-2117

Mailing address

900 N John R Wooden Dr
West Lafayette, IN 47907-2117
Phone (765) 650-0727

Other providers in West Lafayette, IN

All providers in West Lafayette, IN · Registered Dietitian in Indiana

Sources for this page

Verify at the official NPI Registry.