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Individual

ERIN LEIGH WOHLFERT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MPT, ATC

Contact information

Practice address
2601 FERRY ST, LAFAYETTE, IN 47904-3061
(765) 448-8000
Mailing address
PO BOX 5545, LAFAYETTE, IN 47903-5545
(765) 448-8000

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05010483A
IN
225100000X
Physical Therapist
2305204924
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000697565
ANTHEM PROVIDER NUMBER
IN
05
201007870
IN
Enumeration date
04/19/2007
Last updated
09/28/2011
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