Amanda Lynn Ponce De Leon, DPT

NPI #1588286132 in Granger, Indiana

Provider Information

NPI Number: 1588286132
Entity Type: Individual
Name: Amanda Lynn Ponce De Leon, DPT
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Physical Therapist
Credential: DPT
Enumeration Date: May 16, 2020
Last Updated: May 16, 2020

Practice Location

Address: 12171 COVERED WAGON CT
City: Granger
State: Indiana
ZIP Code: 46530-7100
Phone: (317) 373-7882

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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