AMANDA LYNN PONCE DE LEON

GRANGER, IN
NPI1588286132
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy225100000X Physical Therapist
(Licence: IN  05013443A)
Enumeration Date2020-05-16
Last Update Date2020-05-16
Business Address
AMANDA LYNN PONCE DE LEON DPT
12171 COVERED WAGON CT
GRANGER, IN 46530-7100
Phone number: 317-373-7882
Mailing Address
AMANDA LYNN PONCE DE LEON DPT
PO BOX 1592
GRANGER, IN 46530-1592
Phone number: 317-373-7882