Provider Demographics
NPI:1477764082
Name:BARTELL, NATHANIEL MARKUS (LAT, ATC)
Entity Type:Individual
Prefix:
First Name:NATHANIEL
Middle Name:MARKUS
Last Name:BARTELL
Suffix:
Gender:M
Credentials:LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 W VESPER ST
Mailing Address - Street 2:
Mailing Address - City:HESSTON
Mailing Address - State:KS
Mailing Address - Zip Code:67062-8927
Mailing Address - Country:US
Mailing Address - Phone:620-327-2227
Mailing Address - Fax:
Practice Address - Street 1:800 MEDICAL CENTER DR
Practice Address - Street 2:SUITE 220
Practice Address - City:NEWTON
Practice Address - State:KS
Practice Address - Zip Code:67114-7808
Practice Address - Country:US
Practice Address - Phone:316-283-6833
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-24
Last Update Date:2009-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS24-004512255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer