Individual
MAE T MANN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
6297 CANAK DR, AVON, IN 46123-7435
(317) 250-9219
Mailing address
6297 CANAK DR, AVON, IN 46123-7435
(173) 250-9219
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05005457A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100266570A
—
IN
Enumeration date
06/28/2007
Last updated
01/24/2024
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