Individual
ALEXIS LILLIAN BRANHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
900 N JOHN R WOODEN DR, WEST LAFAYETTE, IN 47907-2117
(765) 807-2408
Mailing address
900 N JOHN R WOODEN DR, WEST LAFAYETTE, IN 47907-2117
(765) 807-2408
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
07222074000014
IN
Other
Enumeration date
09/08/2020
Last updated
09/08/2020
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