Individual
DAVID W SPROWL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, MSBA
Contact information
Practice address
5050 N CLINTON ST, FORT WAYNE, IN 46825-5886
(260) 484-8551
(260) 484-9603
Mailing address
5050 N CLINTON ST, FORT WAYNE, IN 46825-5886
(260) 484-8551
(260) 484-9603
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05000652A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000173915
ANTHEM
IN
05
—
100357800
—
IN
Enumeration date
10/05/2006
Last updated
01/27/2010
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