Individual provider · NPI-1

Benjamin Lefevre, LAT, ATC

Specialist/Technologist, Athletic Trainer · Brockton, MA

NPI number1164937256
StatusActive
Last updated in NPPESApr 30, 2026

Details

NPI
1164937256
Entity type
Individual (NPI-1)
Name
Benjamin Lefevre
Credential
LAT, ATC
Sex
Male
Sole proprietor
No
Enumeration date
Dec 11, 2017
Certification date
Apr 30, 2026
Last updated
Apr 30, 2026

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
2255A2300X Specialist/Technologist, Athletic Trainer3585MAYes

Practice location

110 Liberty St Ste 1a
Brockton, MA 02301-5674

Phone 508-565-3055

Mailing address

110 Liberty St Ste 1a
Brockton, MA 02301-5674

Phone 508-565-3055

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