Brittany Nicole Domingo, MA, LAT, ATC

Individual provider Active NPI Athletic Trainer · Athens, WV

NPI 1497289482 · NPPES record last updated Feb 23, 2022

Key facts

NPI
1497289482
Entity type
Individual (NPI type 1)
Primary specialty
Athletic Trainer 2255A2300X
Practice address
1000 Vermillion St
Box C688
Athens, WV 24712-9027
Phone
(681) 422-9113
NPI assigned
Apr 17, 2017
Sex
Female
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
Credentials
Master of Arts

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X Yes

Addresses

Primary practice location

1000 Vermillion St
Box C688
Athens, WV 24712-9027

Mailing address

595 Caldwell St Apt a
Princeton, WV 24739-9410
Phone (681) 422-9113

Other providers in Athens, WV

All providers in Athens, WV · Athletic Trainer in West Virginia

Sources for this page

Verify at the official NPI Registry.