Individual
MITCHELL KORY MEYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AT, ATC
Contact information
Practice address
9125 YELLOW TREE CT, FORT WAYNE, IN 46804
(260) 705-7187
Mailing address
9125 YELLOW TREE CT, FORT WAYNE, IN 46804-5935
(260) 705-7187
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT005645
OH
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
10/02/2017
Last updated
07/10/2018
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