Individual
STACY E ISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHYSICAL THERAPIST
Contact information
Practice address
1815 N CAPITOL AVE, STE 600, INDIANAPOLIS, IN 46202-1288
(317) 924-8636
(317) 921-0237
Mailing address
1815 N CAPITOL AVE, STE 600, INDIANAPOLIS, IN 46202-1288
(317) 924-8636
(317) 921-0237
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05010364A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05010364A
PHYSICAL THERAPIST LICENSE NUMBER
IN
Enumeration date
07/20/2010
Last updated
07/20/2010
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