Individual
ADAM EWALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
909 SAGAMORE PKWY W STE 917, WEST LAFAYETTE, IN 47906-1443
(765) 463-0710
(765) 463-0711
Mailing address
PO BOX 781076, DETROIT, MI 48278-1076
(317) 528-4800
(317) 865-1479
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
31006005A
IN
Other
Enumeration date
05/11/2017
Last updated
07/05/2023
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