Breanna Fagg

NPI #1518357433 in Brazil, Indiana

Provider Information

NPI Number: 1518357433
Entity Type: Individual
Name: Breanna Fagg
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Student in an Organized Health Care Education/Training Program
Enumeration Date: Jan 30, 2015
Last Updated: Jan 30, 2015

Practice Location

Address: 8510 N ADVINCULA DR
City: Brazil
State: Indiana
ZIP Code: 47834-7401
Phone: (812) 691-0383

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist/Technologist - Athletic Trainer — Athletic Trainer	2255A2300X
Student in an Organized Health Care Education/Training Program	390200000X	Primary

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