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General NPI Number Information
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NPI Number | 1508254392
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Entity Type | Individual
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Provider Name | REBECCA KAY WERST ATC,LAT
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Gender | Female
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Dates
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Enumeration Date | 12/31/2014
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Last Update Date | 12/31/2014
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Provider Practice Location Address
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Address Line | 1100 MERCER AVE
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City | DECATUR
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State | IN
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Zip | 46733-2303
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Country | US
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Telephone | 260-724-2145
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Fax |
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Provider Business Mailing Address
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Address Line | 2570 W 750 S
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City | GENEVA
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State | IN
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Zip | 46740-9728
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Country | US
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Telephone | 260-849-9000
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Fax | 260-589-2070
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 36000199A
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License Number State | IN
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