Individual
MISS MICHELLE ELIZABETH BRUNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
3844 NEW VISION DR, FORT WAYNE, IN 46845-1724
(260) 483-9933
Mailing address
1229 LOWER HUNTINGTON RD, FORT WAYNE, IN 46819-1355
(336) 263-8216
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05009796A
IN
Other
Enumeration date
05/20/2009
Last updated
07/15/2009
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