Individual
JOSHUA ALLAN MODICA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC, LAT
Contact information
Practice address
ONE UTSA CIRCLE, SAN ANTONIO, TX 78249-1644
(417) 379-5908
(210) 458-4199
Mailing address
20319 LIATRIS LN, SAN ANTONIO, TX 78259-2250
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT5670
TX
Other
Enumeration date
07/24/2017
Last updated
07/24/2017
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