Individual
JILL LOBACZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CST/CFA
Contact information
Practice address
4030 KENTLAND AVE, FORT WAYNE, IN 46808-1510
(260) 705-0819
Mailing address
4030 KENTLAND AVE, FORT WAYNE, IN 46808-1510
(260) 705-0819
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
104849
IN
Other
Enumeration date
03/26/2009
Last updated
03/26/2009
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