Michael Piekarski

Individual provider Active NPI Athletic Trainer · Russiaville, IN

NPI 1336436617 · NPPES record last updated Jul 7, 2011

Key facts

NPI
1336436617
Entity type
Individual (NPI type 1)
Primary specialty
Athletic Trainer 2255A2300X
Practice address
8063 Circling Hawk Dr
Russiaville, IN 46979-9158
Phone
(765) 271-2611
NPI assigned
Jul 7, 2011
Sex
Male
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

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X Yes

Addresses

Primary practice location

8063 Circling Hawk Dr
Russiaville, IN 46979-9158

Mailing address

8063 Circling Hawk Dr
Russiaville, IN 46979-9158

Other providers in Russiaville, IN

All providers in Russiaville, IN · Athletic Trainer in Indiana

Sources for this page

Verify at the official NPI Registry.