NPI 1205232550

Terrance Broussard

Practitioner Athletic Trainer Fishers, IN

Practice location

Address: 12672 Federal Pl, Fishers, IN 46037-7833
Phone: (317) 374-4102

Registered specialties

Athletic Trainer Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 2255A2300X Licence 991572 (IN)

Other Specialist/Technologist providers in Indiana →

Registry record

NPI: 1205232550
Entity type: Individual
Sex (as registered): Male
NPI issued: 14 Nov 2014
Record last updated: 14 Nov 2014

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.