Provider Demographics
NPI:1801454863
Name:STETSON, JOSHUA (ATC, CSCS)
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:
Last Name:STETSON
Suffix:
Gender:M
Credentials:ATC, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 MARIE ST
Mailing Address - Street 2:
Mailing Address - City:WINSLOW
Mailing Address - State:ME
Mailing Address - Zip Code:04901-7255
Mailing Address - Country:US
Mailing Address - Phone:207-432-7546
Mailing Address - Fax:
Practice Address - Street 1:28 MARIE ST
Practice Address - Street 2:
Practice Address - City:WINSLOW
Practice Address - State:ME
Practice Address - Zip Code:04901-7255
Practice Address - Country:US
Practice Address - Phone:207-432-7546
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-04
Last Update Date:2023-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEAT7892255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer