Individual
MR. PAUL KEITH WALNUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAT, ATC, CSCS
Contact information
Practice address
324 E NEW YORK ST, SUITE 300, INDIANAPOLIS, IN 46204-2141
(317) 972-1180
Mailing address
3470 SHERBURNE LN, APT. D, INDIANAPOLIS, IN 46222-1639
(317) 925-0803
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
36000458A
IN
Other
Enumeration date
04/11/2007
Last updated
07/08/2007
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