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1942855465
JASON THOMAS HEROLDT
MUNSTER, IN
NPI
1942855465
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
225200000X Physical Therapy Assistant
(Licence: IN 06005949A)
Enumeration Date
2019-08-02
Last Update Date
2019-08-02
Business Address
JASON THOMAS HEROLDT PTA
1950 45TH ST STE 200
MUNSTER, IN 46321-3958
Phone number: 219-924-6544
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Mailing Address
JASON THOMAS HEROLDT PTA
1652 TIPPECANOE CT
VALPARAISO, IN 46385-6142
Phone number: 219-476-5990
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