Individual
JOSHUA SIDENER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
11130 PARKVIEW CIRCLE DR, FORT WAYNE, IN 46845-1735
(419) 346-8763
Mailing address
5144 TRUEMPER WAY, APT 10, FORT WAYNE, IN 46835-3265
(419) 346-8763
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
36001893A
IN
Other
Enumeration date
09/24/2010
Last updated
03/21/2016
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