| NPI | 1982020327 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL GRANATO Owner 317-385-1620 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist Athletic Trainer |
| Additional Taxonomies | 133NN1002X Nutritionist Nutrition, Education |
| 174H00000X Health Educator | |
| Enumeration Date | 2014-03-10 |
| Last Update Date | 2014-03-10 |