Purdue Sports Medicine Wl

NPI #1053712570 in West Lafayette, Indiana

Provider Information

NPI Number
1053712570
Entity Type
Organization
Organization Name
Purdue Sports Medicine Wl
Primary Specialty
Physical Therapist - Orthopedic
Enumeration Date
Sep 16, 2014
Last Updated
Oct 24, 2014

Practice Location

Address
900 JOHN R WOODEN DRIVE
Address 2
MACKEY ARENA
State
Indiana
ZIP Code
47907
Phone
(765) 494-3245

Authorized Official

Name
JOAN M VAUGHAN
Title
HIPAA PRIVACY OFFICER
Phone
(765) 496-1927

Specialties & Taxonomy Codes

Specialty
Internal Medicine - Sports MedicineSports Medicine
Specialist/Technologist - Athletic TrainerAthletic Trainer
Physical Therapist - OrthopedicOrthopedic

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