Individual
MRS. JENNIFFER GAITE ETCHISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
8905 DUNMORE LN, FORT WAYNE, IN 46804-3449
(260) 804-7819
Mailing address
8905 DUNMORE LN, FORT WAYNE, IN 46804-3449
(260) 804-7819
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05008583A
IN
Other
Enumeration date
06/22/2007
Last updated
11/12/2021
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