Individual
PAIGE FOSSEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATS
Contact information
Practice address
777 ESSEX DR, CHESTERTON, IN 46304-9585
(219) 331-8561
Mailing address
777 ESSEX DR, CHESTERTON, IN 46304-9585
(219) 331-8561
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NONE
ATHLETIC TRAINER
—
Enumeration date
10/18/2018
Last updated
06/28/2019
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