Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 05000695A | IN |
NPI | 1003018094 |
---|---|
Provider Name | Mrs. Mary Ann Webb |
First Address | Decatur, IN 46733-3322 |
Second Address | Decatur, IN 46733-2303 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/06/2007 |
Last Update Date | 08/07/2007 |