Provider Demographics
NPI:1598239568
Name:STERLING, NATHANIEL DALE (MS, LAT, ATC)
Entity Type:Individual
Prefix:MR
First Name:NATHANIEL
Middle Name:DALE
Last Name:STERLING
Suffix:
Gender:M
Credentials:MS, LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:696 W FIREMEN RD
Mailing Address - Street 2:
Mailing Address - City:VINCENNES
Mailing Address - State:IN
Mailing Address - Zip Code:47591-7068
Mailing Address - Country:US
Mailing Address - Phone:812-899-0510
Mailing Address - Fax:
Practice Address - Street 1:421 E VAN TREES ST
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:IN
Practice Address - Zip Code:47501-2948
Practice Address - Country:US
Practice Address - Phone:812-899-0510
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-14
Last Update Date:2021-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2255A2300X
20000393102255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer