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Individual

ANDREW BRUBAKER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
113 SUSAN WAY DR, RICHMOND, KY 40475-9694
(859) 248-0425
Mailing address
113 SUSAN WAY DR, RICHMOND, KY 40475-9694
(859) 248-0425

Taxonomy

Speciality
Code
Description
License number
State
146N00000X
Basic Emergency Medical Technician
060495082
IL
2255A2300X
Athletic Trainer
Primary
096.003575
IL

Other

Enumeration date
04/30/2014
Last updated
04/30/2014
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