Individual
SHANNA BROYLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9000 S COUNTY ROAD 800 W, DALEVILLE, IN 47334-9420
(765) 644-0500
(765) 378-9019
Mailing address
9000 S COUNTY ROAD 800 W, DALEVILLE, IN 47334-9420
(765) 644-0500
(765) 378-9019
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
06002431A
IN
Other
Enumeration date
05/21/2015
Last updated
05/21/2015
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