Individual
MIRANDA ALEXIS COOMBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
3320 N CLINTON ST, FORT WAYNE, IN 46805-1918
(260) 483-2100
Mailing address
5835 LAKESHORE RD, LEXINGTON, MI 48450-9389
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
0501525A
IN
Other
Enumeration date
06/08/2023
Last updated
06/08/2023
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