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Individual

JUSTIN MATHEW KIESEL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPT

Contact information

Practice address
6280 N COLLEGE AVE STE 300, INDIANAPOLIS, IN 46220-2029
(317) 251-0500
(317) 251-0600
Mailing address
600 OAKMONT LN STE 600C, WESTMONT, IL 60559-5548
(630) 575-6200

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05013406A
IN

Other

Enumeration date
04/12/2019
Last updated
05/04/2021
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