Individual
BRUCE WILLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAT, ATC
Contact information
Practice address
201 PENNSYLVANIA PARKWAY, THOMAS A BRADY SPORTS MEDICINE CENTER PC, INDIANAPOLIS, IN 46280
(317) 491-5464
Mailing address
10356 PARKSHORE DR, FISHERS, IN 46038-5511
(317) 491-5464
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
36000670A
IN
Other
Enumeration date
03/27/2014
Last updated
03/27/2014
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