Mohammad Jabbar Al-Fatlawi, MAT LAT ATC

Individual provider Active NPI Athletic Trainer · Erie, PA

NPI 1992513477 · NPPES record last updated Dec 30, 2024

Key facts

NPI
1992513477
Entity type
Individual (NPI type 1)
Primary specialty
Athletic Trainer 2255A2300X
License
RT008092 (PA)
Practice address
8161 Oliver Rd
Erie, PA 16509-4600
Phone
(814) 860-8788
NPI assigned
Dec 30, 2024
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

State licenses

LicenseStateTypeSpecialty
RT008092PAMDAthletic Trainer

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X RT008092 PA Yes

Addresses

Primary practice location

8161 Oliver Rd
Erie, PA 16509-4600

Mailing address

545 W 31St St
Erie, PA 16508-1742
Phone (814) 860-8788

Other providers in Erie, PA

All providers in Erie, PA · Athletic Trainer in Pennsylvania

Sources for this page

Verify at the official NPI Registry.