Brent Theriault, ATC Valid NPI

Individual provider · Athletic Trainer · Auburn, AL

NPI

1740715192

Type

Individual (Type 1)

Primary specialty

Athletic Trainer (Specialist/Technologist)

Specialty group

Respiratory, Developmental, Rehabilitative and Restorative Service Providers

Taxonomy code

2255A2300X

License number

1794 (AL)

Sex

Male

Sole proprietor

No

Enumerated

2017-04-24

Last updated

2017-04-24