IndividualActive
Braden Phetkhamchanh
NPI 1003487638 · Athletic Trainer · Oskaloosa, IA
Provider details
- NPI number
- 1003487638
- Entity type
- Individual
- Primary specialty
- Athletic TrainerRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Sex
- Male
- Sole proprietor
- No
Mailing address
1917 S Stoneybrook St
Wichita, KS 67207-7111
Registry dates
- Enumerated
- 2021-07-06
- Last updated
- 2021-07-06
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.