Thomas, Brent Michael

Thomas, Brent Michael is an individual health care provider with primary practice located at 2601 Ferry St , Lafayette IN 47904-3061. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer, which is considered as his primary health care specialty. Thomas, Brent Michael can be contacted via phone (765) 448-8000.

Contact Information

Primary practice address
2601 Ferry St Lafayette IN 47904-3061
Phone: (765) 448-8000
Fax: (765) 448-8335
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer 2255A2300X 36001130A Indiana

Profile Details

NPI number 1134189228
LBN Legal business name Thomas, Brent Michael
Credentials Athletic Trainer, Certified (ATC)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 24th, 2006
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1134189228 NPPES
Indiana Other 000000188968 ANTHEM PIN NUMBER

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