Individual
JONATHON HABESHY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
4180 SAGE BLUFF XING, FORT WAYNE, IN 46804-2363
(260) 443-7320
Mailing address
4180 SAGE BLUFF XING, FORT WAYNE, IN 46804-2363
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
06004069A
IN
Other
Enumeration date
06/01/2015
Last updated
06/01/2015
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