Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
BRYAN JOSEPH DOMITRZ, ATC, LAT
Active Sole ProprietorBRYAN JOSEPH DOMITRZ, ATC, LAT is a Athletic Trainer healthcare provider located in NORMAL, Illinois. NPI 1871186304 is currently active in the NPPES registry. Verify at CMS.
Athletic Trainer · NORMAL, IL
Registration Details
- NPI Number
- 1871186304
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Feb 16, 2021 (5.4497040625605 yrs)
- Last Updated
- Feb 16, 2021
- License
-
096.004969 (IL)
- Sole Proprietor
- Yes
Practice Information
- Address
-
501 N PARKSIDE RDNORMAL, IL, 617612780Browse IL providers · Browse ZIP 61761
- Phone
- 3095574402
- Primary Specialty
-
Athletic Trainer
2255A2300X
Other Athletic Trainer Providers in NORMAL, IL
| Name | Credential | NPI |
|---|---|---|
| MR. JOSEPH HADEN WHITSON | ATC | 1710955380 |
| MS. KATHY M PLINE | ATC/L | 1972562510 |
| AUDREY JO HANSEN | ATC | 1154381952 |
| MR. JOHN MUNN III | MS, ATC | 1134163769 |
| TODD A MCLODA | PHD, ATC | 1114945185 |
| DR. WILLIAM O KAUTH SR. | PH.D, ATC | 1134148323 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.