Individual
MR. CARL D LANDIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
953 HANDLEBAR RD, MISHAWAKA, IN 46544-6647
(574) 258-9091
Mailing address
953 HANDLEBAR RD, MISHAWAKA, IN 46544-6647
(574) 258-9091
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
36000124A
IN
Other
Enumeration date
10/17/2006
Last updated
07/08/2007
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