Individual
LESLIE COLWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5801 W BETHEL AVE, MUNCIE, IN 47304-9549
(765) 288-2155
Mailing address
5822 RIVER RUN TRL, FORT WAYNE, IN 46825-6028
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
32002841A
IN
Other
Enumeration date
05/20/2015
Last updated
05/20/2015
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