Individual
MRS. LEUTICIA DIANNE MARKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
25 S BOEHNE CAMP RD, EVANSVILLE, IN 47712-3101
(812) 423-7568
(812) 423-7468
Mailing address
10009 GALLEON COURT, EVANSVILLE, IN 47725
(812) 402-3826
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
06003090A
IN
Other
Enumeration date
07/02/2007
Last updated
07/08/2007
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