Individual
MARK SEXTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC, DPT
Contact information
Practice address
3534 BROOKLYN AVE, FORT WAYNE, IN 46809
(260) 478-5230
Mailing address
4251 LAHMEYER RD, FORT WAYNE, IN 46815-5676
(260) 432-4700
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05012905A
IN
2255A2300X
Athletic Trainer
36002423A
IN
Other
Enumeration date
08/29/2016
Last updated
05/17/2018
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