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1073973855
DANIEL TODD WASYLK
FORT WAYNE, IN
NPI
1073973855
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist Athletic Trainer
(Licence: IN 36001783A)
Enumeration Date
2016-03-07
Last Update Date
2016-03-07
Business Address
MR. DANIEL TODD WASYLK
11130 PARKVIEW CIRCLE DR
FORT WAYNE, IN 46845-1735
Phone number: 260-710-1908
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Mailing Address
MR. DANIEL TODD WASYLK
11111 HOAGLAND RD
HOAGLAND, IN 46745-9582
Phone number:
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