NPI 1083121917

Brent Alexander Roark, ATC

Practitioner Athletic Trainer Athens, WV

Practice location

Address: 1000 Vermillion St, Athens, WV 24712-9027
Phone: (304) 384-6320
Fax: (304) 384-5117

Registered specialties

Athletic Trainer Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 2255A2300X Licence AT001370 (WV)

Other Specialist/Technologist providers in West Virginia →

Registry record

NPI: 1083121917
Entity type: Individual
Sex (as registered): Male
NPI issued: 31 Dec 2017
Record last updated: 31 Dec 2017

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.