MEDICARE: JOSHUA DAVID CORBEIL PT, ATC, CSCS, PES,

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	05008472A	IN

General Provider Information

NPI Number	:	1437140662
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSHUA DAVID CORBEIL PT, ATC, CSCS, PES,

Provider Business Mailing Address
First Line	:	5836 SHIPWATCH PL
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46237-9190
Country	:	US
Telephone Number	:	317-460-5004
Fax Number	:	317-917-2929

Provider Business Practice Location Address
First Line	:	125 S PENNSYLVANIA ST
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46204-3610
Country	:	US
Telephone Number	:	317-917-2940
Fax Number	:	317-917-2929

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/05/2005
Last Update Date	:	07/08/2007

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