Individual
ANGELA MARIE GRUBBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
2741 N SALISBURY ST, WEST LAFAYETTE, IN 47906-1499
(765) 464-5106
Mailing address
467 CORMORANT CT, LAFAYETTE, IN 47909-8193
(765) 586-0947
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
06004299A
IN
Other
Enumeration date
06/23/2021
Last updated
06/23/2021
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