Individual
KYLE O'BRIEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
1148 FRAN LIN PKWY, MUNSTER, IN 46321-3607
(219) 680-9114
Mailing address
1148 FRAN LIN PKWY, MUNSTER, IN 46321-3607
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/22/2015
Last updated
02/01/2017
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