Individual
EVAN JURJEVIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3946 ICE WAY, FORT WAYNE, IN 46805-1018
(260) 266-4007
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701
Taxonomy
Speciality
Code
Description
License number
State
2251S0007X
Sports Physical Therapist
Primary
05014201A
IN
Other
Enumeration date
06/17/2021
Last updated
06/30/2021
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