Individual
ALYSIA R ATHY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
52565 IN-933, SOUTH BEND, IN 46637
(574) 247-7044
Mailing address
52565 IN 933, SOUTH BEND, IN 46637-1632
(574) 247-7044
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
28251732A
IN
Other
Enumeration date
08/12/2021
Last updated
08/12/2021
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