Individual
MRS. ELIZABETH MARY STAUBACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPT
Contact information
Practice address
6040 W 84TH ST, INDIANAPOLIS, IN 46278-1360
(317) 802-2000
Mailing address
6040 W 84TH ST, INDIANAPOLIS, IN 46278-1360
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05008421A
IN
Other
Enumeration date
07/20/2018
Last updated
07/20/2018
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