John Entriken, ATC

Individual provider Active NPI Athletic Trainer · Kutztown, PA

NPI 1750416749 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1750416749
Entity type
Individual (NPI type 1)
Primary specialty
Athletic Trainer 2255A2300X
License
RT000660A (PA)
Practice address
15200 Kutztown Rd
Kutztown Sports Medicine
Kutztown, PA 19530-9335
Phone
(610) 683-4085
NPI assigned
Feb 22, 2007
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

State licenses

LicenseStateTypeSpecialty
RT000660APAMDAthletic Trainer

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X RT000660A PA Yes

Addresses

Primary practice location

15200 Kutztown Rd
Kutztown Sports Medicine
Kutztown, PA 19530-9335

Mailing address

369 N Kemp St
Kutztown, PA 19530-1241
Phone (610) 683-6748

Other providers in Kutztown, PA

All providers in Kutztown, PA · Athletic Trainer in Pennsylvania

Sources for this page

Verify at the official NPI Registry.