Individual
MR. BENJAMIN BRADFORD FRASER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC, LAT, CSCS
Contact information
Practice address
ATHLETIC TRAINING DEPARTMENT C-06, INDIANA STATE UNIVERSITY, TERRE HAUTE, IN 47809-0001
(812) 237-8232
Mailing address
ATHLETIC TRAINING DEPARTMENT C-06, INDIANA STATE UNIVERSITY, TERRE HAUTE, IN 47809-0001
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
36001450A
IN
Other
Enumeration date
11/06/2007
Last updated
11/06/2007
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