Individual
ANNE AJIYI BAMIDELE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
2400 CHATEAU DR, MUNCIE, IN 47303-1900
(765) 747-9045
Mailing address
3601 W MOORE RD, MUNCIE, IN 47304-5947
(765) 289-9542
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
06003312A
IN
225X00000X
Occupational Therapist
Primary
31005495A
IN
Other
Enumeration date
10/16/2008
Last updated
03/06/2024
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