Individual
JEANNE VAIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
332 W 806 N, VALPARAISO, IN 46385-7973
(219) 764-4888
(219) 764-7676
Mailing address
PO BOX 2385, PORTAGE, IN 46368-5885
(219) 764-4888
(219) 764-7676
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
32000109A
IN
Other
Enumeration date
12/11/2012
Last updated
12/11/2012
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