Organization
MIDWEST MYOFUNCTIONAL AND SPEECH THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JULIE A CARRICO SLP (SPEECH-LANGUAGE PATHOLOGIST)
(260) 438-1430
Entity
Organization
Contact information
Practice address
7221 ENGLE RD STE 225, FORT WAYNE, IN 46804-2229
(260) 438-1430
Mailing address
10909 W SYCAMORE HILLS DR, FORT WAYNE, IN 46814-9335
(260) 438-1430
Taxonomy
Speciality
Code
Description
License number
State
261QH0700X
Hearing and Speech Clinic/Center
Primary
—
—
Other
Enumeration date
06/05/2019
Last updated
06/05/2019
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