Individual
DENA WILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1019 BAYOU ST, VINCENNES, IN 47591-2731
(812) 885-2364
Mailing address
1019 BAYOU ST, VINCENNES, IN 47591-2731
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
06001505A
IN
Other
Enumeration date
01/22/2007
Last updated
07/08/2007
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