Individual
MARY STOLLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
1005 N HICKORY RD, SOUTH BEND, IN 46615-3723
(574) 233-5754
Mailing address
1005 N HICKORY RD, SOUTH BEND, IN 46615-3723
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05011538A
IN
Other
Enumeration date
06/08/2016
Last updated
06/08/2016
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