Individual
MR. REY ANGIOLO B SEBASTIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPT
Contact information
Practice address
729 W 35TH ST, MARION, IN 46953-4215
(765) 674-3371
(765) 677-5411
Mailing address
2650 W KEM RD, MARION, IN 46952-9258
(765) 384-4103
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05004150
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000352295
ANTHEM
IN
Enumeration date
04/20/2007
Last updated
07/08/2007
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