IndividualActive
Brett Waldon, MS, ATC, LAT, CSCS
NPI 1457408353 · Athletic Trainer · Russellville, AR
Provider details
- NPI number
- 1457408353
- Entity type
- Individual
- Primary specialty
- Athletic TrainerRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Credential
- MS, ATC, LAT, CSCS
- Sex
- Male
- Sole proprietor
- Yes
- License
- AT313 (AR)
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Practice location
1306 N El Paso Ave
Russellville, AR 72801-8814
Phone: (479) 968-0642
Fax: (479) 498-6044
Approximate (ZIP-level) locationGet directions
Mailing address
4520 Victoria Dr
Fort Smith, AR 72904-6364
Registry dates
- Enumerated
- 2007-01-04
- Last updated
- 2015-07-16
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.