Individual
MRS. PATRICIA J STACKHOUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
1111 RONALD REAGAN PKWY, SUITE MG214, AVON, IN 46123-7085
(317) 217-3070
(317) 217-3073
Mailing address
7 E 70TH ST, INDIANAPOLIS, IN 46220-1001
(317) 251-8686
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05001279A
IN
Other
Enumeration date
04/23/2007
Last updated
01/14/2009
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