Individual
KAYLEY O'CONNOR COLVIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4935 HILLEGAS RD STE 200, FORT WAYNE, IN 46818-1934
(262) 033-8124
Mailing address
PO BOX 80867, FORT WAYNE, IN 46898-0867
(260) 338-1241
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
05013041A
IN
Other
Enumeration date
08/06/2018
Last updated
08/06/2018
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