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1053738047
BRUCE WILLARD
INDIANAPOLIS, IN
NPI
1053738047
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: IN 36000670A)
Enumeration Date
2014-03-27
Last Update Date
2014-03-27
Business Address
-- BRUCE WILLARD LAT, ATC
201 PENNSYLVANIA PARKWAY THOMAS A BRADY SPORTS MEDICINE CENTER PC
INDIANAPOLIS, IN 46280
Phone number: 317-491-5464
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Mailing Address
-- BRUCE WILLARD LAT, ATC
10356 PARKSHORE DR
FISHERS, IN 46038-5511
Phone number: 317-491-5464
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