Individual
MRS. TESSA LYNN DEFORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
406 N 1ST ST, SUITE B, VINCENNES, IN 47591-1340
(812) 885-2770
(812) 886-4958
Mailing address
406 N 1ST ST, SUITE B, VINCENNES, IN 47591-1340
(812) 885-2770
(812) 886-4958
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
06003155A
IN
Other
Enumeration date
11/17/2006
Last updated
07/08/2007
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