Individual
CANDICE MARIE GREATHOUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3630 HICKORY ROAD, MISHAWAKA, IN 46545
(574) 252-7225
Mailing address
29272 OLD US 20, ELKHART, IN 46514-9464
(574) 220-0987
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
06003651A
IN
Other
Enumeration date
02/25/2019
Last updated
02/25/2019
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