Individual provider · Type 1 NPI

William Brack

Student in an Organized Health Care Education/Training Program · Wilkes Barre, PA

NPI number 1770065310 Active

Practice location

133 N River St
Wilkes Barre, PA 18711-0800

Call (888) 546-4772 Map

Mailing address

4 Wisner Ct
Warwick, NY 10990-2121

Specialties and licenses

TaxonomyCodeLicense
Athletic Trainer 2255A2300XNone listed
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1770065310

William Brack's National Provider Identifier is 1770065310, issued on Aug 30, 2018. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Wilkes Barre, PA. The record was last updated on Aug 30, 2018.