Individual
JOSEPH MCCUDDEN
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
(630) 514-9880
Mailing address
6510 COVINGTON RD, E317, FORT WAYNE, IN 46804-7350
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
36002294A
IN
Other
Enumeration date
10/16/2013
Last updated
03/04/2016
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