Individual
KRISTEN MACY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
201 E RUDISILL BLVD STE 301, FORT WAYNE, IN 46806-1756
(260) 348-9887
Mailing address
3384 RIDERS TRL, FORT WAYNE, IN 46814-0005
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
31004953A
IN
Other
Enumeration date
02/23/2019
Last updated
02/23/2019
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