Individual
MRS. MONNETT PETILOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPT
Contact information
Practice address
2872 E. DUPONT RD, FORT WAYNE, IN 46825
(260) 497-0838
(260) 497-9088
Mailing address
1213 BLUFF POINTE WAY, FORT WAYNE, IN 46845-2058
(260) 490-7049
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05007695A
IN
Other
Enumeration date
05/17/2007
Last updated
07/08/2007
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