NPI 1285198010

Brandi Jean Richard, LATATC

Practitioner Athletic Trainer Bolingbrook, IL

Practice location

Address: 790 Remington Blvd, Bolingbrook, IL 60440-4909
Phone: (630) 551-6704
Mailing address: 27 Fieldpoint Rd, Montgomery, IL 60538-2607

Registered specialties

Athletic Trainer Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 2255A2300X Licence 096005352 (IL)

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Registry record

NPI: 1285198010
Entity type: Individual
Sex (as registered): Female
NPI issued: 25 Jan 2019
Record last updated: 16 Nov 2024

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.