Individual
MR. EVAN JAY BARTUSEK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS, ATC
Contact information
Practice address
605 WASHINGTON ST, FAYETTE, IA 52142-9206
(563) 425-5664
Mailing address
605 WASHINGTON ST, FAYETTE, IA 52142-9206
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
000657
IA
Other
Enumeration date
06/21/2010
Last updated
06/21/2010
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