Individual
MS. NICOLE JEANEE DESMARETZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1616 ROKOSZ LN, DYER, IN 46311-1394
(219) 331-8260
Mailing address
1616 ROKOSZ LN, DYER, IN 46311-1394
(219) 331-8260
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160006254
IL
Other
Enumeration date
11/25/2012
Last updated
11/25/2012
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