Individual
JENNIFER L RUBALCADA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1101 W OAKDALE DR, FORT WAYNE, IN 46807-1747
(260) 246-0132
Mailing address
1101 W OAKDALE DR, FORT WAYNE, IN 46807-1747
Taxonomy
Speciality
Code
Description
License number
State
405300000X
Prevention Professional
Primary
NA
IN
Other
Enumeration date
08/09/2019
Last updated
08/09/2019
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