Individual
JESSICA MACLEOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11104 PARKVIEW CIRCLE DR STE 440, FORT WAYNE, IN 46845-1672
(260) 373-9935
(260) 373-9926
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10003645A
IN
Other
Enumeration date
08/18/2020
Last updated
08/02/2024
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