Candy Anderson, LAT, ATC

Individual provider Active NPI Athletic Trainer · Terre Haute, IN

NPI 1396055422 · NPPES record last updated Oct 7, 2010

Key facts

NPI
1396055422
Entity type
Individual (NPI type 1)
Primary specialty
Athletic Trainer 2255A2300X
License
36001687A (IN)
Practice address
567 N 5TH St
Terre Haute, IN 47809-1903
Phone
(812) 237-4066
NPI assigned
Oct 7, 2010
Sex
Female
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
36001687AINMDAthletic Trainer

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 36001687A IN Yes

Addresses

Primary practice location

567 N 5TH St
Terre Haute, IN 47809-1903

Mailing address

567 N 5TH St
Terre Haute, IN 47809-1903
Phone (812) 237-4066

Other providers in Terre Haute, IN

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

Sources for this page

Verify at the official NPI Registry.