Richard Bertie, M.S., LAT, ATC, PES

Individual provider Active NPI Athletic Trainer · Loretto, PA

NPI 1245646504 · NPPES record last updated Jul 8, 2014

Key facts

NPI
1245646504
Entity type
Individual (NPI type 1)
Primary specialty
Athletic Trainer 2255A2300X
License
RT005723 (PA)
Practice address
117 Evergreen Dr
Stokes Athletic Center, Saint Francis University
Loretto, PA 15940-9704
Phone
(570) 951-9952
NPI assigned
Jul 8, 2014
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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
RT005723PAMDAthletic Trainer

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X RT005723 PA Yes

Addresses

Primary practice location

117 Evergreen Dr
Stokes Athletic Center, Saint Francis University
Loretto, PA 15940-9704

Mailing address

PO Box 169
188 Mahanoy St.
Nuremberg, PA 18241-0169
Phone (570) 951-9952

Other providers in Loretto, PA

All providers in Loretto, PA · Athletic Trainer in Pennsylvania

Sources for this page

Verify at the official NPI Registry.