Individual
BOSEDE RUTH FASAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1070 W JEFFERSON ST, FRANKLIN, IN 46131-2179
(973) 953-5584
Mailing address
1331 GLEN CANYON DR, GREENWOOD, IN 46143-5583
(973) 953-5584
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
06004399A
IN
Other
Enumeration date
04/03/2023
Last updated
04/03/2023
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