Brian Betz

Individual provider Active NPI Athletic Trainer · West Terre Haute, IN

NPI 1306357207 · NPPES record last updated Oct 18, 2017

Key facts

NPI
1306357207
Entity type
Individual (NPI type 1)
Primary specialty
Athletic Trainer 2255A2300X
License
36002632A (IN)
Practice address
4590 W Sarah Myers Dr
West Terre Haute, IN 47885-9507
Phone
(631) 487-5667
NPI assigned
Oct 18, 2017
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

State licenses

LicenseStateTypeSpecialty
36002632AINMDAthletic Trainer

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 36002632A IN Yes

Addresses

Primary practice location

4590 W Sarah Myers Dr
West Terre Haute, IN 47885-9507

Mailing address

4590 W Sarah Myers Dr
West Terre Haute, IN 47885-9507

Other providers in West Terre Haute, IN

All providers in West Terre Haute, IN · Athletic Trainer in Indiana

Sources for this page

Verify at the official NPI Registry.