Healthcare Provider Details

I. General information

NPI: 1275927345
Provider Name (Legal Business Name): ERIN PLATT ATC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2015
Last Update Date: 03/26/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2610 ENTERPRISE DR
ANDERSON IN
46013-9684
US

IV. Provider business mailing address

12824 HOWE RD
FISHERS IN
46038-3609
US

V. Phone/Fax

Practice location:
  • Phone: 765-683-4400
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number36001698A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: