Individual
MR. DANIEL TODD WASYLK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
11130 PARKVIEW CIRCLE DR, FORT WAYNE, IN 46845-1735
(260) 710-1908
Mailing address
11111 HOAGLAND RD, HOAGLAND, IN 46745-9582
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
36001783A
IN
Other
Enumeration date
03/07/2016
Last updated
03/07/2016
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