Individual
GAVIN MICHAEL GLEASON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4125 N SPRINGBORO RD, BROOKSTON, IN 47923-7056
(765) 822-0553
Mailing address
4125 N SPRINGBORO RD, BROOKSTON, IN 47923-7056
(765) 822-0553
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
IN
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
IN
Other
Enumeration date
12/01/2025
Last updated
12/01/2025
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