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Individual

PATRICK JOMO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
4628 CRAFTSBURY CIR, FORT WAYNE, IN 46818-2063
(260) 418-8599
Mailing address
4628 CRAFTSBURY CIR, FORT WAYNE, IN 46818-2063
(260) 418-8599

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
28165197A
IN

Other

Enumeration date
03/06/2014
Last updated
03/12/2014
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