Individual
ANDREW STEPHEN MISNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
510 N GRANDSTAFF DR, AUBURN, IN 46706-1660
(260) 927-9270
(260) 927-9272
Mailing address
4251 LAHMEYER RD, FORT WAYNE, IN 46815-5676
(260) 432-4700
(260) 459-9262
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05010612A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100257920B
GROUP MEDICAID
IN
01
—
156546
GROUP MEDICARE
IN
Enumeration date
07/26/2011
Last updated
07/26/2011
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