National Provider Identifier
Brett James Walters
Brett James Walters is listed in the NPPES registry with a primary specialty of Student in an Organized Health Care Education/Training Program in Ithaca, NY and a listed phone number of (607) 274-1456.
Profile Overview
- NPI
- 1942979166
- Provider Type
- Individual
- Primary Specialty
- Student in an Organized Health Care Education/Training Program
- Enumeration Date
- September 10, 2021
- Last Updated
- September 10, 2021
Practice Location
- 953 Danby RD
- Ithaca, NY 14850-7000
Phone: (607) 274-1456
Mailing Address
- 953 Danby RD
- Ithaca, NY 14850-7002
Specialties
- Student in an Organized Health Care Education/Training Program (390200000X)
- Athletic Trainer (2255A2300X)
Full Record
- NPI
- 1942979166
- Entity Type
- Individual
- Last Name
- Walters
- First Name
- Brett
- Middle Name
- James
- Name Prefix
- Mr.
- Mailing Street Address
- 953 Danby RD
- Mailing City
- Ithaca
- Mailing State
- NY
- Mailing ZIP Code
- 14850-7002
- Mailing Country
- US
- Mailing Phone
- (607) 274-1456
- Practice Street Address
- 953 Danby RD
- Practice City
- Ithaca
- Practice State
- NY
- Practice ZIP Code
- 14850-7000
- Practice Country
- US
- Practice Phone
- (607) 274-1456
- Enumeration Date
- September 10, 2021
- Last Updated
- September 10, 2021
- Sex
- Male
- Sole Proprietor
- No
- Certification Date
- September 10, 2021
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Student in an Organized Health Care Education/Training Program (390200000X), Athletic Trainer (2255A2300X)