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1699047266
KELLY L MAUCH
FORT WAYNE, IN
NPI
1699047266
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Former Name
KELLY L BREHM
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: IN 05001649A)
Enumeration Date
2012-01-30
Last Update Date
2012-01-30
Business Address
-- KELLY L MAUCH PT
5800 FAIRFIELD AVE STE 150
FORT WAYNE, IN 46807-3450
Phone number: 260-744-5585
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Mailing Address
-- KELLY L MAUCH PT
5800 FAIRFIELD AVE STE 150
FORT WAYNE, IN 46807-3450
Phone number: 260-744-5585
Copy
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