Individual
MR. PAUL EDWARD WIDNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC, LAT
Contact information
Practice address
2101 N MAIN ST, NAPPANEE, IN 46550-9310
(574) 773-4127
(574) 773-4099
Mailing address
2101 N MAIN ST, NAPPANEE, IN 46550-9310
(574) 773-4127
(574) 773-4099
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
36000256A
IN
Other
Enumeration date
02/17/2010
Last updated
02/17/2010
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