Individual
JUSTIN EUTSLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
4814 W WALLEN RD, FORT WAYNE, IN 46818-9407
(260) 609-3753
Mailing address
4814 W WALLEN RD, FORT WAYNE, IN 46818-9407
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
32002131A
IN
Other
Enumeration date
09/18/2015
Last updated
09/18/2015
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