Individual
MS. BRITTANI MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAT ATC
Contact information
Practice address
5228 THRASHER DR, INDIANAPOLIS, IN 46254-3563
(317) 281-5539
Mailing address
5228 THRASHER DR, INDIANAPOLIS, IN 46254-3563
(317) 281-5539
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
36001755A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2330864354
CASH
—
Enumeration date
11/29/2020
Last updated
06/05/2024
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