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

Jackson Ryan Brunner, LAT, ATC

Individual provider Athletic Trainer · NPI 1821563453

Jackson Ryan Brunner, LAT, ATC is an Athletic Trainer in Normal, Illinois. Licensed in Illinois. Registered with an NPI since 2018.

Licensed in
IL
In the registry since
2018
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.

See every abbreviation used in this directory →

Practice location Address checks out

7160 Athletics Kaufman Football Bldg
Normal, IL 61790-6953
Phone: (309) 438-0607
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Athletic Trainer (primary) Taxonomy 2255A2300X · Licence 096.004944 (IL)

Record details

NPI number1821563453
Entity typeIndividual (Type 1)
GenderMale
Credentials LAT , ATC
Sole proprietorNo
NPI enumeratedOctober 10, 2018
Last updated in NPPESSeptember 28, 2021
Certification dateSeptember 28, 2021

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