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Individual

JADE ELISE LAW

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PTC

Contact information

Practice address
4737 HEATHERWIND DR, FORT WAYNE, IN 46815-7134
(260) 302-8529
Mailing address
4604 HEATHERWIND DR APT D, FORT WAYNE, IN 46815-7136

Taxonomy

Speciality
Code
Description
License number
State
246RP1900X
Phlebotomy Technician
Primary
PTC8958
IN

Other

Enumeration date
07/01/2024
Last updated
07/01/2024
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