Individual
MRS. AMANDA RAYPOLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
13725 PIEDMONT CV, FORT WAYNE, IN 46845-9170
(260) 760-0188
Mailing address
13725 PIEDMONT CV, FORT WAYNE, IN 46845
(260) 760-0188
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
31003751
IN
Other
Enumeration date
07/07/2014
Last updated
07/07/2014
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