Provider Demographics
NPI:1053762799
Name:CADLE, JOSHUA (ATC, LAT)
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:
Last Name:CADLE
Suffix:
Gender:M
Credentials:ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2149 HANLEY RD N
Mailing Address - Street 2:
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:MI
Mailing Address - Zip Code:49085-2915
Mailing Address - Country:US
Mailing Address - Phone:269-873-8866
Mailing Address - Fax:
Practice Address - Street 1:5376 SUMMERSONG DR APT 19
Practice Address - Street 2:
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49015-9517
Practice Address - Country:US
Practice Address - Phone:269-873-8866
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-23
Last Update Date:2019-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI26010022142255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer