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Bryan Black, MAT, LAT, ATC, CKTP
NPI 1407358377 · on the registry since 2018
Practice
- Address
- 3946 Ice Way Fort Wayne
Fort Wayne, IN 46808 - Phone
- (517) 425-4996
Registry record
- Primary taxonomy
- Athletic Trainer
2255A2300X
- Licence states on file
- IN
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2018-03-06
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Indiana