Individual
PETER A PAONESSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
7601 W JEFFERSON BLVD, FORT WAYNE, IN 46804-4133
(260) 436-8686
(260) 432-5075
Mailing address
7601 W JEFFERSON BLVD, FORT WAYNE, IN 46804-4133
(260) 436-8686
(260) 432-5075
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05000862A
IN
Other
Enumeration date
05/24/2005
Last updated
07/08/2007
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