Brian Collette
Individual provider Active NPI Athletic Trainer · Dakota Dunes, SD
NPI 1962867952 · NPPES record last updated Dec 18, 2015
Key facts
- NPI
- 1962867952
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Athletic Trainer 2255A2300X
- License
- 0320 (SD)
- Practice address
- 575 N Sioux Point Rd
Dakota Dunes, SD 57049-5312 - Phone
- (605) 217-2617
- NPI assigned
- Dec 18, 2015
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| 00276 | IA | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 0320 | SD | Yes |
| Athletic Trainer | 2255A2300X | 00276 | IA |
Addresses
Primary practice location
575 N Sioux Point Rd
Dakota Dunes, SD 57049-5312
Mailing address
575 N Sioux Point Rd
Dakota Dunes, SD 57049-5312
Other providers in Dakota Dunes, SD
- Jana Chadwick
- Kip D Chesmore
- Megan Cleveland
- Carrie Lynn Closter
- Cnos PC
- Michelle Kay Connor
- John Edward Cook
- Kimberly Cooper
- Carol Copeland
- Kimberly Renee Coy
All providers in Dakota Dunes, SD · Athletic Trainer in South Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 18, 2015. 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.