Individual
STACEY KIM HUMMEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
316 WOODIES LN, BREMEN, IN 46506-1354
(574) 546-3494
Mailing address
324 BURKET LN, BREMEN, IN 46506-1977
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
06003185A
IN
Other
Enumeration date
12/26/2017
Last updated
12/26/2017
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