Individual
BRIAN FABRIES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C, ATC
Contact information
Practice address
253 SAGAMORE PKWY W, WEST LAFAYETTE, IN 47906-1501
(765) 409-8556
Mailing address
1924 ABNAKI WAY, WEST LAFAYETTE, IN 47906-5488
(765) 409-8556
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
36002774A
IN
363A00000X
Physician Assistant
10004877A
IN
363A00000X
Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
36002774A
ATHLETIC TRAINER
IN
Enumeration date
05/25/2017
Last updated
07/25/2025
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