Individual
DR. NICHOLAS JOSEPH DEWALD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
9614 LIMA RD STE 104, FORT WAYNE, IN 46818-9279
(260) 442-6025
Mailing address
12894 GANNET CT, FORT WAYNE, IN 46845-1285
(260) 442-6025
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
08003397A
IN
Other
Enumeration date
12/11/2023
Last updated
12/11/2023
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