Individual
SARAH ANNE MANVILLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MED, LAT, ATC
Contact information
Practice address
8112 N 200 W, FORTVILLE, IN 46040-9747
(734) 365-3453
Mailing address
8112 N 200 W, FORTVILLE, IN 46040-9747
(734) 365-3453
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
36001637A
IN
Other
Enumeration date
01/24/2014
Last updated
01/24/2014
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