Individual
JACOB THOMAS BRUNEMANN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS, ATC
Contact information
Practice address
2440 CONCORD DR, LOUISVILLE, KY 40217-1832
(812) 209-9320
Mailing address
2440 CONCORD DR, LOUISVILLE, KY 40217-1832
(812) 209-9320
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT1519
KY
Other
Enumeration date
08/21/2019
Last updated
08/21/2019
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