Individual
DIDYMUS OMAR ACADEMIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
3600 W BETHEL AVE, MUNCIE, IN 47304-5407
(765) 213-3870
Mailing address
3813 S MADISON ST, MUNCIE, IN 47302-5758
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05005962A
IN
Other
Enumeration date
10/14/2008
Last updated
10/14/2008
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