Individual
KAYLA HAGAN FEARON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
815 WASHINGTON ST, ROCKPORT, IN 47635-1252
(812) 649-2276
Mailing address
2600 COMPASS RD, GLENVIEW, IL 60026-8001
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
06006432A
IN
Other
Enumeration date
11/01/2022
Last updated
11/01/2022
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