Individual
JARED WAYNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.P.T
Contact information
Practice address
4005 LANCASTER DR, VALPARAISO, IN 46383-1953
(219) 510-2256
Mailing address
PO BOX 1702, VALPARAISO, IN 46384-1702
(219) 510-2256
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05011203A
IN
Other
Enumeration date
08/06/2013
Last updated
07/01/2023
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