Individual
GRACE WEBSTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4935 HILLEGAS RD, FORT WAYNE, IN 46818-1934
(260) 338-1241
Mailing address
PO BOX 80867, FORT WAYNE, IN 46898-0867
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
06004844A
IN
Other
Enumeration date
01/28/2015
Last updated
10/03/2018
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