Individual
ETHAN EDWARD STUMP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
2170 COMMERCE DR, BLUFFTON, IN 46714-9292
(260) 824-0522
(260) 824-0522
Mailing address
4251 LAHMEYER RD, FORT WAYNE, IN 46815-5676
(260) 432-4700
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
31008755A
IN
Other
Enumeration date
06/30/2025
Last updated
06/30/2025
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