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1104240902
BRETT SPACK
CARMEL, IN
NPI
1104240902
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: IN 36002164A)
Enumeration Date
2014-02-13
Last Update Date
2014-02-13
Business Address
Mr. BRETT SPACK ATC, LAT
1402 CHASE CT
CARMEL, IN 46032-7502
Phone number: 317-848-5867
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Mailing Address
Mr. BRETT SPACK ATC, LAT
5131 CALLAN DR
INDIANAPOLIS, IN 46254-3774
Phone number: 317-246-8715
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