Individual
BRISTOL AUBURN WITTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT, CCH
Contact information
Practice address
3215 N ANTHONY BLVD STE D, FORT WAYNE, IN 46805-2259
(260) 704-2323
Mailing address
6457 FLUTTER RD, FORT WAYNE, IN 46835-9720
(260) 704-2323
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT21806580
IN
Other
Enumeration date
12/29/2019
Last updated
12/29/2019
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