Individual
JACOB CHASE KANABY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
53880 CARMICHAEL DR, SOUTH BEND, IN 46635-1567
(574) 247-9441
(574) 247-9442
Mailing address
3600 W BETHEL AVE, MUNCIE, IN 47304-5407
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05015554A
IN
Other
Enumeration date
05/16/2024
Last updated
06/20/2024
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