Individual
BRADY DEJONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAT, ATC, MSAT
Contact information
Practice address
701 N C ST, INDIANOLA, IA 50125-1201
(515) 961-6251
Mailing address
1705 BEVERLY DR, KNOXVILLE, IA 50138-1613
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
114877
IA
Other
Enumeration date
10/28/2024
Last updated
10/28/2024
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