Individual
NATHANIEL COLGLAZIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
11104 PARKVIEW CIRCLE DR STE 410, FORT WAYNE, IN 46845-0025
(260) 266-5260
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10002350A
IN
363A00000X
Physician Assistant
—
—
Other
Enumeration date
10/13/2017
Last updated
10/10/2022
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