Individual
ELLEN JEAN EATON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
2505 E JEFFERSON BLVD, SOUTH BEND, IN 46615-2635
(574) 289-3945
Mailing address
15744 SUNRISE TRL, GRANGER, IN 46530-9034
(574) 360-1527
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
31001875A
IN
Other
Enumeration date
08/12/2019
Last updated
08/12/2019
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