Individual
SARA MATTEUCCI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3102 MALLARD COVE LN, FORT WAYNE, IN 46804-2882
(317) 435-7045
Mailing address
4959 REED RD, FORT WAYNE, IN 46835-3549
(317) 435-7045
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT21003352
IN
Other
Enumeration date
09/17/2014
Last updated
09/17/2014
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