Individual
JENNIFER ANN BOYLAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
300 E WASHINGTON BLVD, FORT WAYNE, IN 46802-3124
(260) 417-9540
(260) 454-2083
Mailing address
300 E WASHINGTON BLVD, FORT WAYNE, IN 46802-3124
(260) 417-9540
(260) 454-2083
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
32001789A
IN
Other
Enumeration date
12/11/2019
Last updated
12/11/2019
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