Individual
DEBRA SUE IMBODY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.T.
Contact information
Practice address
157 RIVER RD, LIGONIER, IN 46767-9537
(260) 894-9909
Mailing address
8259 WICKER AVE, SAINT JOHN, IN 46373-8878
(219) 365-6559
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
31000369
IN
Other
Enumeration date
03/07/2007
Last updated
09/05/2019
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