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1538725130
NATHAN D BACON
WEST LAFAYETTE, IN
NPI
1538725130
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: IN 05013332A)
Enumeration Date
2019-05-20
Last Update Date
2022-01-11
Business Address
NATHAN D BACON DPT
307 SAGAMORE PKWY W STE 400
WEST LAFAYETTE, IN 47906-1500
Phone number: 765-463-2200
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Mailing Address
NATHAN D BACON DPT
5383 AUSTIN DR
MONTICELLO, IN 47960-6531
Phone number: 812-614-1928
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