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NPI Code Detail

MEDICARE: MS. VICTORIA GRACE HUDSON ATS

MEDICARE: MS. VICTORIA GRACE HUDSON ATS
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 Trainer

General Provider Information

NPI Number : 1003765413
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. VICTORIA GRACE HUDSON ATS
Provider Business Mailing Address
First Line : 900 N JOHN R WOODEN DR
Second Line :
City : WEST LAFAYETTE
State : IN
Zip : 47907-2117
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 900 N JOHN R WOODEN DR
Second Line :
City : WEST LAFAYETTE
State : IN
Zip : 47907-2117
Country : US
Telephone Number : 765-496-0502
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/27/2026
Last Update Date : 01/27/2026

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Directions to “ MS. VICTORIA GRACE HUDSON ATS” Practice Location

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