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NPI Code Detail

MEDICARE: BREANNA LEIGH LEHMAN MS, LAT, ATC

MEDICARE:   BREANNA LEIGH LEHMAN  MS, LAT, ATC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12255A2300XAthletic Trainer36004146AIN

General Provider Information

NPI Number : 1821832304
Entity Type Code : Individual
Provider Name (Legal Business Name) : BREANNA LEIGH LEHMAN MS, LAT, ATC
Provider Business Mailing Address
First Line : 3946 ICE WAY
Second Line :
City : FORT WAYNE
State : IN
Zip : 46805-1018
Country : US
Telephone Number : 260-633-0333
Fax Number :
Provider Business Practice Location Address
First Line : 3946 ICE WAY
Second Line :
City : FORT WAYNE
State : IN
Zip : 46805-1018
Country : US
Telephone Number : 260-633-0333
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/20/2024
Last Update Date : 06/05/2026

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Directions to “ BREANNA LEIGH LEHMAN MS, LAT, ATC” Practice Location

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