Individual
MR. JOSEPH GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAT, ATC
Contact information
Practice address
11130 PARKVIEW CIRCLE DR, FORT WAYNE, IN 46845-1735
(260) 443-4100
Mailing address
11130 PARKVIEW CIRCLE DR, FORT WAYNE, IN 46845-1735
(260) 443-4199
Taxonomy
Speciality
Code
Description
License number
State
246Z00000X
Other Specialist/Technologist
Primary
36002065A
IN
Other
Enumeration date
03/22/2016
Last updated
03/22/2016
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