Individual
CRAIG LEE MIDDLEBROOK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LAT, ATC
Contact information
Practice address
200 N 7TH ST, TERRE HAUTE, IN 47809-1902
(360) 689-2134
Mailing address
784 CALICO CT, TERRE HAUTE, IN 47803-4258
(360) 689-2134
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
36001732A
IN
2255A2300X
Athletic Trainer
A1 60047440
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
070702056
BOC
—
Enumeration date
09/27/2010
Last updated
09/27/2010
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