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Contact Information

BRUCE WILLARD, LAT, ATC
201 PENNSYLVANIA PARKWAY
THOMAS A BRADY SPORTS MEDICINE CENTER PC
INDIANAPOLIS, IN46280
 Phone: 317-491-5464
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Athletic Trainer

2255A2300X
Indicates primary specialty

NPI Profile & details for BRUCE WILLARD · (Male)

NPI Number 1053738047
Status Active
Credentials LAT, ATC
Entity Individual
Enumeration date 03/27/2014
Last updated 03/27/2014 - About 12 years ago
Sole proprietor 1 No
Identifiers
  • IN License # 36000670A
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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