Individual
BRAYANA N FOWLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
9337 AMBERSTONE LN APT 936, NOBLESVILLE, IN 46060-5323
(765) 461-1326
Mailing address
9337 AMBERSTONE LN APT 936, NOBLESVILLE, IN 46060-5323
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0
N/A
—
Enumeration date
03/12/2021
Last updated
03/12/2021
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