Individual
MRS. SARA J GERGELY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
3001 S CREASY LN STE 100A, LAFAYETTE, IN 47905
(765) 420-5800
Mailing address
3001 S CREASY LN STE 100A, LAFAYETTE, IN 47905-5206
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
36001261A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000197905
ANTHEM PROVIDER NUMBER
IN
Enumeration date
03/24/2006
Last updated
02/25/2019
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