Individual
JULIE MCGILL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3105 BEACON ST, FORT WAYNE, IN 46805-2447
(260) 450-4239
Mailing address
3105 BEACON ST, FORT WAYNE, IN 46805-2447
(260) 450-4239
Taxonomy
Speciality
Code
Description
License number
State
347C00000X
Private Vehicle
Primary
1700609704
IN
Other
Enumeration date
10/27/2017
Last updated
10/27/2017
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