Individual
MARISA THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10021 DUPONT CIRCLE CT, FORT WAYNE, IN 46825-1604
(260) 426-8117
Mailing address
11260 SPORTSMAN PARK LN UNIT 203, FORT WAYNE, IN 46845-2161
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
23002918A
IN
Other
Enumeration date
06/23/2025
Last updated
06/23/2025
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