Provider Demographics
NPI:1841696218
Name:BRATRUD, SHARON ROBIN (MS, ATC, LAT)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:ROBIN
Last Name:BRATRUD
Suffix:
Gender:F
Credentials:MS, ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:811 10TH ST NW
Mailing Address - Street 2:
Mailing Address - City:VALLEY CITY
Mailing Address - State:ND
Mailing Address - Zip Code:58072-2050
Mailing Address - Country:US
Mailing Address - Phone:701-845-7678
Mailing Address - Fax:
Practice Address - Street 1:811 10TH ST NW
Practice Address - Street 2:
Practice Address - City:VALLEY CITY
Practice Address - State:ND
Practice Address - Zip Code:58072-2050
Practice Address - Country:US
Practice Address - Phone:701-845-7678
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-13
Last Update Date:2014-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND429-112255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer