Individual
CAROL C FIENHAGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
812 W WHITE RIVER BLVD, MUNCIE, IN 47303-3868
(765) 468-8872
Mailing address
412 N MAIN ST, FARMLAND, IN 47340-9796
(765) 468-8872
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
31002888A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000105227
ANTHEM BCBS
IN
Enumeration date
02/13/2007
Last updated
07/08/2007
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