Individual
MARY DEVOTA DUBACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA, WCC, CLT
Contact information
Practice address
4321 FIR ST, EAST CHICAGO, IN 46312-3049
(219) 392-7400
(219) 392-7408
Mailing address
4321 FIR ST, EAST CHICAGO, IN 46312-3049
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
06002220A
IN
Other
Enumeration date
05/31/2018
Last updated
05/31/2018
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