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Contact Information

NICHOLAS BRIGGS ELLENBERGER, LAT,ATC
3125 S WOOD BLVD
GOODYEAR, AZ85338
 Phone: 315-723-0512
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Athletic Trainer

2255A2300X
Indicates primary specialty

NPI Profile & details for NICHOLAS BRIGGS ELLENBERGER · (Male)

NPI # 1609666817
Status Active
Credentials LAT,ATC
Entity Individual
Enumeration date 05/09/2025
Last updated 05/09/2025 - More than a year ago
Sole proprietor 1 No
Identifiers
  • AZ License # ATR-009509
  • FL License # AL6761
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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