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1003677964
AUTUMN AXLINE
SOUTH BEND, IN
NPI
1003677964
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363A00000X Physician Assistant
Enumeration Date
2024-01-18
Last Update Date
2024-01-18
Business Address
AUTUMN AXLINE PA
211 N EDDY ST
SOUTH BEND, IN 46617-2808
Phone number: 574-234-8161
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Mailing Address
AUTUMN AXLINE PA
26621 HAMILTON ST
EDWARDSBURG, MI 49112-9691
Phone number: 574-855-9892
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