Individual
EMILY JEANE MIZE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3946 ICE WAY, FORT WAYNE, IN 46805-1018
(260) 444-2788
Mailing address
3946 ICE WAY, FORT WAYNE, IN 46805-1018
(260) 306-1005
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
09/27/2021
Last updated
05/28/2022
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