Individual
CRYSTAL PIKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
240 BEECHMONT DR NE, CORYDON, IN 47112-1718
(812) 738-8127
Mailing address
240 BEECHMONT DR NE, CORYDON, IN 47112-1718
(812) 738-8127
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
31004601A
IN
Other
Enumeration date
07/02/2008
Last updated
07/02/2008
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