Individual
JOSHUA STORK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC, LAT, MBA
Contact information
Practice address
3601 S CALHOUN ST, FORT WAYNE, IN 46807-2006
(260) 249-9534
Mailing address
11130 PARKVIEW CIRCLE DR, FORT WAYNE, IN 46845-1735
(260) 249-9534
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
36001441A
IN
Other
Enumeration date
03/27/2014
Last updated
03/02/2016
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