IndividualActive
Alissa Niswonger, MS, LAT, ATC
NPI 1922547215 · Athletic Trainer · Fort Wayne, IN
Provider details
- NPI number
- 1922547215
- Entity type
- Individual
- Primary specialty
- Athletic TrainerRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Credential
- MS, LAT, ATC
- Sex
- Female
- Sole proprietor
- No
- License
- 005105 (OH)
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Practice location
3946 Ice Way
Fort Wayne, IN 46805-1018
Phone: (219) 861-9144
Approximate (ZIP-level) locationGet directions
Mailing address
1000 W Fountain Grove Dr
Bryan, OH 43506
Registry dates
- Enumerated
- 2017-02-20
- Last updated
- 2024-12-04
- Certified
- 2024-12-04
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.