Individual
JOLYN M PITZER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05010162A
IN
225200000X
Physical Therapy Assistant
06003319A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05010162A
LICENSE
IN
01
—
06003319A
LICENSE
IN
Enumeration date
11/06/2009
Last updated
01/04/2011
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