Individual
BRIAN SCOTT BULMER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
200 W CARLISLE ST, MOORESVILLE, IN 46158-1527
(317) 831-9208
Mailing address
200 W CARLISLE ST, MOORESVILLE, IN 46158-1527
(317) 831-9208
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
36000891A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
22
22
IN
Enumeration date
12/13/2017
Last updated
12/13/2017
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