Individual
NICOLE M BOBAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPT, WCS, CIMT, CSCS
Contact information
Practice address
10228 DUPONT CIRCLE DR E STE 100, FORT WAYNE, IN 46825-1611
(260) 222-7401
(260) 209-5956
Mailing address
PO BOX 772437, DETROIT, MI 48277-2437
(317) 575-7304
(317) 575-7333
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05007516A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000208508
ANTHEM
IN
Enumeration date
10/02/2006
Last updated
02/01/2023
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