Individual
BRIAN ISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
1756 W 100 S, PORTLAND, IN 47371-8204
(260) 726-4020
Mailing address
3813 S MADISON ST, MUNCIE, IN 47302-5758
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
06002259A
IN
Other
Enumeration date
03/26/2007
Last updated
07/08/2007
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