Individual
CALVIN BISSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
3946 ICE WAY, FORT WAYNE, IN 46805-1018
(419) 506-1229
Mailing address
3946 ICE WAY, FORT WAYNE, IN 46805-1018
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
36001865A
IN
Other
Enumeration date
12/30/2019
Last updated
12/30/2019
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