Individual
BRENT STAUTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
6727 EVERGLADES CT, INDIANAPOLIS, IN 46217-3920
(480) 603-7650
Mailing address
6727 EVERGLADES CT, INDIANAPOLIS, IN 46217-3920
(480) 603-7650
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05014664A
IN
Other
Enumeration date
07/04/2006
Last updated
04/18/2024
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