| NPI | 1093137911 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARRETT ALLEN HUEBER Athletic Trainer 317-750-9584 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: IN 36002185A) |
| Enumeration Date | 2014-01-12 |
| Last Update Date | 2014-01-12 |