Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Bruce Willard, LAT, ATC

Individual provider Athletic Trainer · NPI 1053738047

Bruce Willard, LAT, ATC is an Athletic Trainer in Indianapolis, Indiana. Licensed in Indiana. Registered with an NPI since 2014.

Licensed in
IN
In the registry since
2014
What do these letters mean?
LAT — Licensed Athletic Trainer
A state-licensed athletic trainer.
ATC — Certified Athletic Trainer
Prevents and treats sport and activity injuries.

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Practice location Address checks out

201 Pennsylvania Parkway Thomas A Brady Sports Medicine Center Pc
Indianapolis, IN 46280
Phone: (317) 491-5464
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Athletic Trainer (primary) Taxonomy 2255A2300X · Licence 36000670A (IN)

Record details

NPI number1053738047
Entity typeIndividual (Type 1)
GenderMale
Credentials LAT , ATC
Sole proprietorNo
NPI enumeratedMarch 27, 2014
Last updated in NPPESMarch 27, 2014
Mailing address10356 Parkshore Dr, Fishers, IN 46038-5511

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