Individual
HALEY BRANDT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3320 N CLINTON ST, FORT WAYNE, IN 46805-1918
(260) 483-2100
Mailing address
3320 N CLINTON ST, FORT WAYNE, IN 46805-1918
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05012125A
IN
Other
Enumeration date
08/23/2016
Last updated
08/23/2016
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