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General NPI Number Information
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NPI Number | 1053762799
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Entity Type | Individual
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Provider Name | JOSHUA CADLE ATC, LAT
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Gender | Male
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Dates
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Enumeration Date | 06/23/2016
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Last Update Date | 06/01/2019
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Provider Practice Location Address
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Address Line | 5376 SUMMERSONG DR APT 19
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City | BATTLE CREEK
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State | MI
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Zip | 49015-9517
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Country | US
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Telephone | 269-873-8866
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Fax |
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Provider Business Mailing Address
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Address Line | 2149 HANLEY RD N
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City | SAINT JOSEPH
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State | MI
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Zip | 49085-2915
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Country | US
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Telephone | 269-873-8866
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 2601002214
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License Number State | MI
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