Individual
MR. BOITUMELO JOHN EDMUND MASHALA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
P.T.A
Contact information
Practice address
1150 CHESTNUT CT, APT H, GREENCASTLE, IN 46135-7309
(574) 596-1539
Mailing address
1150 CHESTNUT CT, APT H, GREENCASTLE, IN 46135-7309
(574) 596-1539
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
06004423A
IN
Other
Enumeration date
06/17/2014
Last updated
06/17/2014
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