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NPI Code Detail

MEDICARE: CHRISTINE ANNE LAUBER ATC

MEDICARE:   CHRISTINE ANNE LAUBER  ATC
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 : 1275664369
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTINE ANNE LAUBER ATC
Provider Business Mailing Address
First Line : 8108 SOUTHERN SPRINGS BLVD
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46237-9282
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1400 E HANNA AVE
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46227-3630
Country : US
Telephone Number : 317-788-2516
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/08/2007
Last Update Date : 07/08/2007

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Directions to “ CHRISTINE ANNE LAUBER ATC” Practice Location

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