NPI 1003487638

Braden Ashvin Phetkhamchanh

Practitioner Athletic Trainer Oskaloosa, IA

Practice location

Address: 201 Trueblood Ave, Oskaloosa, IA 52577-1757
Phone: (641) 673-1093
Mailing address: 1917 S Stoneybrook St, Wichita, KS 67207-7111

Registered specialties

Athletic Trainer Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 2255A2300X

Other Specialist/Technologist providers in Iowa →

Registry record

NPI: 1003487638
Entity type: Individual
Sex (as registered): Male
NPI issued: 6 Jul 2021
Record last updated: 6 Jul 2021

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.