Individual
SANDRA KAY VANCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3320 N CLINTON ST, FORT WAYNE, IN 46805-1918
(260) 483-2100
(260) 484-5059
Mailing address
3320 N CLINTON ST, FORT WAYNE, IN 46805-1918
(260) 483-2100
(260) 484-5059
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
31000141A
IN
Other
Enumeration date
02/21/2012
Last updated
02/21/2012
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