Organization
FORTIFY PHYSICAL THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JONATHAN LYNN DETTMER DPT (MEMBER)
(260) 414-7827
Entity
Organization
Contact information
Practice address
216 MARCIEL DR, FORT WAYNE, IN 46825-5310
(260) 414-7827
Mailing address
6408 CONSTITUTION DR, FORT WAYNE, IN 46804-1558
(260) 414-7827
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
12/27/2023
Last updated
01/02/2024
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