Provider Demographics
NPI:1316462831
Name:SELTZ, JOSH (ATC)
Entity type:Individual
Prefix:
First Name:JOSH
Middle Name:
Last Name:SELTZ
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2719 N 14TH ST
Mailing Address - Street 2:
Mailing Address - City:FORT DODGE
Mailing Address - State:IA
Mailing Address - Zip Code:50501-7216
Mailing Address - Country:US
Mailing Address - Phone:515-570-2157
Mailing Address - Fax:
Practice Address - Street 1:2719 N 14TH ST
Practice Address - Street 2:
Practice Address - City:FORT DODGE
Practice Address - State:IA
Practice Address - Zip Code:50501-7216
Practice Address - Country:US
Practice Address - Phone:515-570-2157
Practice Address - Fax:515-570-2157
Is Sole Proprietor?:No
Enumeration Date:2017-08-05
Last Update Date:2017-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer