Individual
KIRSTEN E AULT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
9418 W COUNTY ROAD 300 S, MEDORA, IN 47260-9709
(812) 521-0054
(812) 966-2407
Mailing address
9418 W COUNTY ROAD 300 S, MEDORA, IN 47260-9709
(812) 521-0054
(812) 966-2407
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
06003508A
IN
Other
Enumeration date
05/15/2008
Last updated
05/15/2008
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