BRIAN THOMAS RAYPOLE

FORT WAYNE, IN
NPI1477512564
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: IN  36001169A)
Enumeration Date2006-03-20
Last Update Date2007-07-08
Business Address
Mr. BRIAN THOMAS RAYPOLE LAT ATC
5050 N. CLINTON STREET
FORT WAYNE, IN 46809
Phone number: 260-484-8551
Mailing Address
Mr. BRIAN THOMAS RAYPOLE LAT ATC
3609 BLUEGRASS LN
FORT WAYNE, IN 46815-6455
Phone number: 260-485-2985
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