Provider Demographics
NPI:1710195938
Name:STRAUB, BRIAN MATTHEW (ATC, LAT, NASM-CES)
Entity Type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:MATTHEW
Last Name:STRAUB
Suffix:
Gender:M
Credentials:ATC, LAT, NASM-CES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 WINDSOR WAY
Mailing Address - Street 2:
Mailing Address - City:RED LION
Mailing Address - State:PA
Mailing Address - Zip Code:17356-8788
Mailing Address - Country:US
Mailing Address - Phone:817-716-0197
Mailing Address - Fax:
Practice Address - Street 1:1855 POWDER MILL RD
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17402-4723
Practice Address - Country:US
Practice Address - Phone:817-716-0197
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-20
Last Update Date:2021-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTATR-LAT-LIC-13842255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer