MATTHEW LEE DEBOLT

ROANOKE, IN
NPI1730503327
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy225200000X Physical Therapy Assistant
(Licence: CA  10320)
Enumeration Date2014-02-18
Last Update Date2014-02-18
Business Address
Mr. MATTHEW LEE DEBOLT PTA
11015 YALUMBA PASS
ROANOKE, IN 46783-8931
Phone number: 260-402-1968
Mailing Address
Mr. MATTHEW LEE DEBOLT PTA
11015 YALUMBA PASS
ROANOKE, IN 46783-8931
Phone number: 260-402-1968
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