THERESA M SPADE

FORT WAYNE, IN
NPI1982605804
Former NameTHERESA M MINNICK
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy225100000X Physical Therapist
(Licence: IN  05002068A)
Enumeration Date2005-08-02
Last Update Date2007-07-08
Business Address
-- THERESA M SPADE PT
7601 W JEFFERSON BLVD
FORT WAYNE, IN 46804-4133
Phone number: 260-436-8686
Mailing Address
-- THERESA M SPADE PT
PO BOX 2526
FORT WAYNE, IN 46801-2526
Phone number: 260-436-8686
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