DANIEL WALLACE FOX

FORT WAYNE, IN
NPI1831168434
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: IN  36000038A)
Enumeration Date2006-03-16
Last Update Date2016-03-03
Business Address
-- DANIEL WALLACE FOX ATC
11130 PARKVIEW CIRCLE DR
FORT WAYNE, IN 46845-1735
Phone number: 260-445-3575
Mailing Address
-- DANIEL WALLACE FOX ATC
11130 PARKVIEW CIRCLE DR
FORT WAYNE, IN 46845-1735
Phone number: 260-445-3575
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