BENJAMIN CHAZ CHARLES

FORT WAYNE, IN
NPI1548762495
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: IN  36002726A)
Enumeration Date2018-03-07
Last Update Date2018-03-07
Business Address
Mr. BENJAMIN CHAZ CHARLES MAT, LAT, ATC
3946 ICE WAY
FORT WAYNE, IN 46808
Phone number: 920-619-0184
Mailing Address
Mr. BENJAMIN CHAZ CHARLES MAT, LAT, ATC
3946 ICE WAY
FORT WAYNE, IN 46808
Phone number: 920-619-0184
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