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Individual

CAROLINE MIA FUNKHOUSER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT, DPT

Contact information

Practice address
2605 E CREEKS EDGE DR, BLOOMINGTON, IN 47401-8368
(812) 333-2663
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05014737A
IN

Other

Enumeration date
11/14/2022
Last updated
12/27/2022
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