Individual
MS. MARY ALICE CHILDERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4040 LOUDENS CHAPEL RD NW, DEPAUW, IN 47115-8745
(812) 972-0009
Mailing address
4040 LOUDENS CHAPEL RD NW, DEPAUW, IN 47115-8745
(812) 972-0009
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Enumeration date
08/19/2010
Last updated
08/19/2010
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