Individual
MR. MICHAEL TODD VANBRUGGEN
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
2130 S BRANNER AVE, CN BOX 72030, JEFFERSON CITY, TN 37760-2224
(865) 471-3368
(865) 471-3514
Mailing address
2130 S BRANNER AVE, CN BOX 72030, JEFFERSON CITY, TN 37760-2224
(865) 471-3368
(865) 471-3514
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
561
TN
2255A2300X
Athletic Trainer
AT1345
TX
Other
Enumeration date
02/10/2006
Last updated
07/08/2007
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