Individual
GIFTY MARY THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7843 W JEFFERSON BLVD, FORT WAYNE, IN 46804-4137
(260) 432-4848
Mailing address
7843 W JEFFERSON BLVD, FORT WAYNE, IN 46804-4137
(260) 432-4848
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05012815A
IN
Other
Enumeration date
12/27/2023
Last updated
12/27/2023
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