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Individual

CRAIG DISS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PTA

Contact information

Practice address
2625 CREEPING PHLOX CV, FORT WAYNE, IN 46818-8942
(260) 450-4828
Mailing address
2625 CREEPING PHLOX CV, FORT WAYNE, IN 46818-8942
(260) 450-4828

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
06004292A
IN

Other

Enumeration date
08/12/2014
Last updated
08/12/2014
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