Individual
KATRINA ELISABETH ROACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
2200 RANDALLIA DR, FORT WAYNE, IN 46805-4638
(260) 373-4500
Mailing address
5148 TRUEMPER WAY APT 9, FORT WAYNE, IN 46835-3219
(260) 485-0286
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
06003339A
IN
Other
Enumeration date
07/10/2007
Last updated
07/10/2007
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