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Individual

MR. BRETT SPACK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
ATC, LAT

Contact information

Practice address
1402 CHASE CT, CARMEL, IN 46032-7502
(317) 848-5867
Mailing address
5131 CALLAN DR, INDIANAPOLIS, IN 46254-3774
(317) 246-8715

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
36002164A
IN

Other

Enumeration date
02/13/2014
Last updated
02/13/2014
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