| Amanda Lynn Ponce De Leon, DPT | |
|
12171 Covered Wagon Ct, Granger, IN 46530-7100 | |
| (317) 373-7882 | |
| Not Available |
| Full Name | Amanda Lynn Ponce De Leon |
|---|---|
| Gender | Female |
| Speciality | Physical Therapist |
| Location | 12171 Covered Wagon Ct, Granger, Indiana |
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588286132 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | 05013443A (Indiana) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Amanda Lynn Ponce De Leon, DPT Po Box 1592, Granger, IN 46530-1592 Ph: (317) 373-7882 | Amanda Lynn Ponce De Leon, DPT 12171 Covered Wagon Ct, Granger, IN 46530-7100 Ph: (317) 373-7882 |
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