Individual
NATHAN D BACON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
307 SAGAMORE PKWY W STE 400, WEST LAFAYETTE, IN 47906-1500
(765) 463-2200
(765) 463-3625
Mailing address
5383 AUSTIN DR, MONTICELLO, IN 47960-6531
(812) 614-1928
(765) 449-1196
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05013332A
IN
Other
Enumeration date
05/20/2019
Last updated
01/11/2022
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