Individual
GARRETT VANDERSAUL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
204 BROWNWOOD AVE, COLUMBIA CITY, IN 46725-1702
(260) 229-7157
Mailing address
204 BROWNWOOD AVE, COLUMBIA CITY, IN 46725-1702
(260) 229-7157
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
36002971A
IN
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
09/07/2016
Last updated
03/01/2022
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