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NPI Code Detail

MEDICARE: MR. BRANDIN A WILLIAMS AT, ATC

MEDICARE: MR. BRANDIN A WILLIAMS AT, 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 TrainerAT005654OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10OTHERSELF

General Provider Information

NPI Number : 1639666159
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. BRANDIN A WILLIAMS AT, ATC
Provider Business Mailing Address
First Line : 8251 PINE RD STE 212
Second Line :
City : CINCINNATI
State : OH
Zip : 45236-2194
Country : US
Telephone Number : 513-232-2663
Fax Number :
Provider Business Practice Location Address
First Line : 8251 PINE RD STE 212
Second Line :
City : CINCINNATI
State : OH
Zip : 45236-2194
Country : US
Telephone Number : 513-232-2663
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/19/2018
Last Update Date : 04/14/2026

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Directions to “ MR. BRANDIN A WILLIAMS AT, ATC” Practice Location

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