Individual
STEPHEN ENYIAKU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5911 W STATE ROAD 46, BLOOMINGTON, IN 47404-9359
(812) 876-6400
Mailing address
5911 W STATE ROAD 46, BLOOMINGTON, IN 47404-9359
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
06005108A
IN
Other
Enumeration date
04/18/2022
Last updated
04/18/2022
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