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Individual

JENNIFER A CHAPMAN

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
P.T.

Contact information

Practice address
3030 LAKE AVE, SUITE 24, FORT WAYNE, IN 46805-5428
(260) 424-8830
(260) 424-8868
Mailing address
829 WILLEN LN, FORT WAYNE, IN 46818
(260) 432-5404

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05007066A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
292775
BCBS PIN #
IN
Enumeration date
04/11/2006
Last updated
07/08/2007
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