Individual
LAURA CHENOWETH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
505 W WOLFE ST, SULLIVAN, IN 47882-9224
(812) 268-6361
Mailing address
80 JENKINS LN, SULLIVAN, IN 47882-7054
(812) 564-0111
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
32000999A
IN
Other
Enumeration date
11/09/2022
Last updated
11/09/2022
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