Individual
ELIZABETH SUSAN CORNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1260 N 17TH ST, LAFAYETTE, IN 47904-2163
(765) 423-6885
Mailing address
1260 N 17TH ST, LAFAYETTE, IN 47904-2163
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
—
Other
Enumeration date
06/05/2017
Last updated
06/05/2017
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