Individual
LAURETTE CANNALEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1185 W CARMEL DR BLDG C, CARMEL, IN 46032-8708
(317) 415-6980
Mailing address
1185 W CARMEL DR BLDG C, CARMEL, IN 46032-8708
(317) 415-6980
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
06003416A
IN
Other
Enumeration date
10/11/2016
Last updated
10/11/2016
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