Individual
KILEY JEAN FURNISH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
604 RENNAKER ST, LA FONTAINE, IN 46940-9045
(765) 981-2081
Mailing address
607 N FARLOOK DR, MARION, IN 46952-2420
(765) 667-2428
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
99088634A
IN
Other
Enumeration date
09/07/2018
Last updated
09/07/2018
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