Healthcare Provider Details

I. General information

NPI: 1710773171
Provider Name (Legal Business Name): NATALIE BRUTSCHER ATC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/15/2025
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2210 DR RANDY MCDANIEL WAY
MIDDLETON FL
34762-6774
US

IV. Provider business mailing address

720 SHADYBROOK DR APT G
AKRON OH
44312-3335
US

V. Phone/Fax

Practice location:
  • Phone: 502-554-2054
  • Fax:
Mailing address:
  • Phone: 502-554-2054
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License NumberAL7783
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: