NPI 1003168436

Molly Wietfeldt

Practitioner Physical Therapy Assistant Fort Wayne, IN

Practice location

Address: 4111 Park Place Dr, Fort Wayne, IN 46845-6002
Phone: (260) 373-2111

Registered specialties

Physical Therapy Assistant Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225200000X Licence 06002681A (IN)

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Registry record

NPI: 1003168436
Entity type: Individual
Sex (as registered): Female
NPI issued: 9 Oct 2012
Record last updated: 9 Oct 2012

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.