Individual
SAMUEL MAUNES III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
2269 W 25TH AVE, GARY, IN 46404-3367
(219) 944-4160
(219) 944-4195
Mailing address
2269 W 25TH AVE, GARY, IN 46404-3367
(219) 944-4160
(219) 944-4195
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05007136A
IN
Other
Enumeration date
07/03/2020
Last updated
07/03/2020
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