Individual
JORGE PABLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
3805 S CALHOUN ST, FORT WAYNE, IN 46807-2010
(260) 497-7191
Mailing address
12844 COLDWATER RD STE B, FORT WAYNE, IN 46845-8833
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05013853A
IN
Other
Enumeration date
09/03/2020
Last updated
09/03/2020
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