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Individual

ANDREA MARIE GLASS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PTA

Contact information

Practice address
10767 ILLINOIS ST, CARMEL, IN 46032-8972
(317) 817-1200
Mailing address
16665 GREENSBORO DR, WESTFIELD, IN 46074-8036
(260) 415-2611

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
06006410A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
06006410A
PHYSICAL THERAPIST ASSISTANT LICENSE
IN
Enumeration date
02/21/2022
Last updated
02/21/2022
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