Bryan Diekmann
Individual provider Active NPI Athletic Trainer · Edwards, CO
NPI 1760903447 · NPPES record last updated Jul 3, 2017
Key facts
- NPI
- 1760903447
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Athletic Trainer 2255A2300X
- Practice address
- 1140 Edwards Village Blvd. Ste 105
Edwards, CO 81632 - Phone
- (970) 569-3260
- NPI assigned
- Jul 3, 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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | Yes |
Addresses
Primary practice location
1140 Edwards Village Blvd. Ste 105
Edwards, CO 81632
Mailing address
PO Box 2743
Edwards, CO 81632-2743
Other providers in Edwards, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 3, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.