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1003168436
MOLLY WIETFELDT
FORT WAYNE, IN
NPI
1003168436
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225200000X Physical Therapy Assistant
(Licence: IN 06002681A)
Enumeration Date
2012-10-09
Last Update Date
2012-10-09
Business Address
-- MOLLY WIETFELDT
4111 PARK PLACE DR
FORT WAYNE, IN 46845-6002
Phone number: 260-373-2111
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Mailing Address
-- MOLLY WIETFELDT
4111 PARK PLACE DR
FORT WAYNE, IN 46845-6002
Phone number: 260-373-2111
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