Individual
JANUARY LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
118 MEDICAL DR, CARMEL, IN 46032-3323
(317) 573-1037
Mailing address
7018 CEDAR KNOLL DR, SELLERSBURG, IN 47172-9478
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
06005758A
IN
Other
Enumeration date
08/09/2018
Last updated
08/09/2018
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