Individual
MARK FORBING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS, LAT, ATC
Contact information
Practice address
410 N CLARK ST, BLOOMINGTON, IN 47408-4182
(260) 385-2560
Mailing address
3946 ICE WAY, FORT WAYNE, IN 46805-1018
(260) 385-2560
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
36002003A
IN
Other
Enumeration date
11/20/2013
Last updated
08/03/2020
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