MR. Paul Edward Widner, ATC, LAT

NPI #1407178577 in Nappanee, Indiana

Provider Information

NPI Number
1407178577
Entity Type
Individual
Name
MR. Paul Edward Widner, ATC, LAT
Gender
Not Specified
Sole Proprietor
Yes
Primary Specialty
Specialist/Technologist - Athletic Trainer
Credential
ATC, LAT
Enumeration Date
Feb 17, 2010
Last Updated
Feb 17, 2010

Practice Location

Address
2101 N MAIN ST
State
Indiana
ZIP Code
46550-9310
Phone
(574) 773-4127

Specialties & Taxonomy Codes

Specialty
Specialist/Technologist - Athletic TrainerAthletic Trainer

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