Individual
BRIAN STEPHEN NITZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
700 N PROGRESS AVE, SILOAM SPRINGS, AR 72761-4349
(479) 524-5134
Mailing address
2203 W GRANITE ST, SILOAM SPRINGS, AR 72761-3315
(479) 220-2964
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT385
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
885931099
NATIONAL ATHLETIC TRAINERS ASSOC. BOARD OF CERTIFICATION
—
Enumeration date
06/10/2017
Last updated
06/10/2017
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