Individual
AGNES LUCAS VIGILIA-MARAYA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHYSICAL THERAPIST
Contact information
Practice address
8110 NORTHBURY DR, FORT WAYNE, IN 46818-1843
(260) 489-3704
(260) 489-3704
Mailing address
8110 NORTHBURY DR, FORT WAYNE, IN 46818-1843
(260) 489-3704
(260) 489-3704
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
PT05002613A
IN
Other
Enumeration date
04/20/2007
Last updated
07/09/2007
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