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1134189228
BRENT MICHAEL THOMAS
LAFAYETTE, IN
NPI
1134189228
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: IN 36001130A)
Enumeration Date
2006-03-24
Last Update Date
2007-07-08
Business Address
-- BRENT MICHAEL THOMAS ATC
2601 FERRY ST
LAFAYETTE, IN 47904-3061
Phone number: 765-448-8000
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Mailing Address
-- BRENT MICHAEL THOMAS ATC
PO BOX 5545
LAFAYETTE, IN 47903-5545
Phone number: 765-448-8000
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