Individual provider · NPI-1

Eilish Mary Anderson, ATC

Specialist/Technologist, Athletic Trainer · Indianapolis, IN

NPI number1063887115
StatusActive
Last updated in NPPESOct 22, 2018

Details

NPI
1063887115
Entity type
Individual (NPI-1)
Name
Eilish Mary Anderson
Credential
ATC
Sex
Female
Sole proprietor
No
Enumeration date
Dec 1, 2015
Last updated
Oct 22, 2018

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
2255A2300X Specialist/Technologist, Athletic Trainer36003061AINYes
2255A2300X Specialist/Technologist, Athletic Trainer096.003993IL

Practice location

201 Pennsylvania Pkwy Ste 100
Indianapolis, IN 46280-1393

Phone 317-817-1200

Mailing address

201 Pennsylvania Pkwy Ste 100
Indianapolis, IN 46280-1393

Phone 317-817-1200

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