National Provider Identifier

Adrian Western, MS, ATC

Adrian Western, MS, ATC is listed in the NPPES registry with a primary specialty of Athletic Trainer in Ithaca, NY and a listed phone number of (607) 252-3580.

NPI 1649691767Ithaca, NYAthletic Trainer

Profile Overview

NPI
1649691767
Provider Type
Individual
Primary Specialty
Athletic Trainer
Enumeration Date
December 16, 2013
Last Updated
December 16, 2013

Practice Location

  • 310 Taughannock Blvd Ste 5A
  • Ithaca, NY 14850-3251

Phone: (607) 252-3580

Mailing Address

  • 559 Brooktondale RD
  • Brooktondale, NY 14817-9401

Specialties

  • Athletic Trainer (2255A2300X)
Full Record
NPI
1649691767
Entity Type
Individual
Last Name
Western
First Name
Adrian
Name Prefix
Mr.
Credential
MS, ATC
Mailing Street Address
559 Brooktondale RD
Mailing City
Brooktondale
Mailing State
NY
Mailing ZIP Code
14817-9401
Mailing Country
US
Practice Street Address
310 Taughannock Blvd Ste 5A
Practice City
Ithaca
Practice State
NY
Practice ZIP Code
14850-3251
Practice Country
US
Practice Phone
(607) 252-3580
Enumeration Date
December 16, 2013
Last Updated
December 16, 2013
Sex
Male
Sole Proprietor
No
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Athletic Trainer (2255A2300X)