Healthcare Provider Details

I. General information

NPI: 1437086519
Provider Name (Legal Business Name): CONNOR JOHN ENGLERT ATC, LAT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2026
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1535 E WOOSTER ST
BOWLING GREEN OH
43403-4046
US

IV. Provider business mailing address

400 E NAPOLEON RD APT 312
BOWLING GREEN OH
43402-4661
US

V. Phone/Fax

Practice location:
  • Phone: 585-623-0069
  • Fax:
Mailing address:
  • Phone: 585-623-0069
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License NumberAT007299
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: