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BRYAN JOSEPH DOMITRZ ATC, LAT
NPI 1871186304
Specialist/Technologist - Athletic Trainer in Normal, IL

Active since February 16, 2021
501 N PARKSIDE RD, NORMAL, IL 61761(309) 557-4402 Get Directions Write a Review

NPPES record last updated: February 16, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Bryan Joseph Domitrz Atc, Lat NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BRYAN JOSEPH DOMITRZ ATC, LAT (NPI 1871186304) is an individual athletic trainer provider in Normal, Illinois, licensed in Illinois (096.004969) and active in the NPI registry since February 2021.

NPPES Registry Identity

NPI1871186304
Entity TypeIndividualMale
Primary Taxonomy2255A2300X
Provider Legal NameBRYAN JOSEPH DOMITRZCredential: ATC, LAT
Location Address501 N PARKSIDE RDNormal, IL 61761-2780
Mailing AddressW792 Potters CirEast Troy, WI 53120-2317 · (414) 828-4911
Phone(309) 557-4402
Sole ProprietorYes
Enumeration DateFebruary 16, 2021
NPPES CertifiedFebruary 16, 2021
✔ NPI 1871186304 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialist/Technologist · Athletic TrainerRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code2255A2300X
License✔ Licensed in IL · 096.004969
Definition
Athletic trainers are allied health care professionals who work in consultation with or under the direction of physicians, and specialize in the prevention, assessment, treatment and rehabilitation of injuries and illnesses. Currently, the entry-level employment requirements are a bachelor's degree with a major in athletic training from an accredited university or college. A majority of athletic trainers hold advanced degrees. National board certification is generally required as a condition of state licensure and employment. Most states regulate athletic trainers, and they practice within the scope of that license or regulation. Clinical practice includes emergency care, rehabilitation, reconditioning, therapeutic exercise, wellness programs, exercise physiology, kinesiology, biomechanics, nutrition, psychology and health care administration.
501 N PARKSIDE RD, Normal, IL 61761
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. MARGARET KATHLEEN MODGLIN MS CCC-SLP/L
Speech-Language Pathologist
501 N PARKSIDE RD
NORMAL, IL 61761
McLean County (309) 336-6272
RYANNE MCDANIEL
Specialist/Technologist (Athletic Trainer)
501 N PARKSIDE RD
NORMAL, IL 61761
McLean County (307) 202-1735
HANNAH ELIZABETH HARRIS
Specialist/Technologist (Athletic Trainer)
501 N PARKSIDE RD
NORMAL, IL 61761
McLean County (309) 557-4402

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Bryan Domitrz's NPI number?

The NPI number for Bryan Domitrz is 1871186304. It was assigned to this individual provider in the NPPES registry on February 16, 2021.

Where is Bryan Domitrz located?

Bryan Domitrz practices at 501 N Parkside Rd, Normal, IL 61761. The listed phone number is (309) 557-4402.

What is Bryan Domitrz's specialty?

The primary specialty registered for this NPI is Specialist/Technologist, specializing in Athletic Trainer, with taxonomy code 2255A2300X.

When was this NPI record last updated?

The NPPES record for Bryan Domitrz was last updated on February 16, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.