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1063121929
CHARLTON PE
LOGANSPORT, IN
NPI
1063121929
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
225100000X Physical Therapist
(Licence: IN 05008048A)
Enumeration Date
2022-11-21
Last Update Date
2022-11-21
Business Address
CHARLTON PE
2635 N ROYAL CENTER PIKE
LOGANSPORT, IN 46947-8671
Phone number: 574-398-1411
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Mailing Address
CHARLTON PE
2635 N ROYAL CENTER PIKE
LOGANSPORT, IN 46947-8671
Phone number: 574-398-1411
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