NPI 1063817104

Michale Diane Rothgeb, PTA

Practitioner Physical Therapy Assistant Fort Wayne, IN

Practice location

Address: 2200 Randollia Dr, Fort Wayne, IN 46805
Phone: (260) 373-3202
Fax: (260) 373-4548
Mailing address: 11109 Parkview Plaza Dr, Fort Wayne, IN 46845

Registered specialties

Physical Therapy Assistant Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225200000X Licence 06003715A (IN)

Other Physical Therapy Assistant providers in Indiana →

Registry record

NPI: 1063817104
Entity type: Individual
Sex (as registered): Female
NPI issued: 31 Oct 2014
Record last updated: 31 Oct 2014

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.