NPI 1093272114

Candice Marie Greathouse

Practitioner Physical Therapy Assistant Mishawaka, IN

Practice location

Address: 3630 Hickory Road, Mishawaka, IN 46545
Phone: (574) 252-7225
Mailing address: 29272 Old US 20, Elkhart, IN 46514-9464

Registered specialties

Physical Therapy Assistant Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225200000X Licence 06003651A (IN)

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Registry record

NPI: 1093272114
Entity type: Individual
Sex (as registered): Female
NPI issued: 25 Feb 2019
Record last updated: 25 Feb 2019

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.