Individual
JENNIFER E COBB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
6040 LUTE RD, PORTAGE, IN 46368-5008
(219) 763-6858
(219) 763-4858
Mailing address
PO BOX 74, WARSAW, IN 46581-0074
(574) 551-8460
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
06003363A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
06003363A
PTA
IN
Enumeration date
07/12/2007
Last updated
07/12/2007
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