Individual
GORDON RAY SINNING III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS, LAT,ATC
Contact information
Practice address
2701 N KINSER PIKE, BLOOMINGTON, IN 47404-1825
(812) 219-9817
Mailing address
2701 N KINSER PIKE, BLOOMINGTON, IN 47404-1825
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
36001194A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
22
ATHLETIC TRAINER
IN
Enumeration date
08/22/2007
Last updated
03/11/2008
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