Brandon Nolt, MS, ATC

Individual provider Active NPI Athletic Trainer · Kutztown, PA

NPI 1891833091 · NPPES record last updated Sep 27, 2007

Key facts

NPI
1891833091
Entity type
Individual (NPI type 1)
Primary specialty
Athletic Trainer 2255A2300X
License
RT003490 (PA)
Practice address
Keystone Hall Room 120
Kutztown University
Kutztown, PA 19530
Phone
(610) 683-4085
Fax
(610) 683-4664
NPI assigned
Feb 1, 2007
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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
RT003490PAMDAthletic Trainer

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X RT003490 PA Yes

Addresses

Primary practice location

Keystone Hall Room 120
Kutztown University
Kutztown, PA 19530

Mailing address

262 Degler Ave
Leesport, PA 19533-9514

Other providers in Kutztown, PA

All providers in Kutztown, PA · Athletic Trainer in Pennsylvania

Sources for this page

Verify at the official NPI Registry.