Provider Demographics
NPI:1437140662
Name:CORBEIL, JOSHUA DAVID (PT, ATC, CSCS, PES,)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:DAVID
Last Name:CORBEIL
Suffix:
Gender:M
Credentials:PT, ATC, CSCS, PES,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5836 SHIPWATCH PL
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46237-9190
Mailing Address - Country:US
Mailing Address - Phone:317-460-5004
Mailing Address - Fax:317-917-2929
Practice Address - Street 1:125 S PENNSYLVANIA ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46204-3610
Practice Address - Country:US
Practice Address - Phone:317-917-2940
Practice Address - Fax:317-917-2929
Is Sole Proprietor?:No
Enumeration Date:2005-11-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05008472A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist