Individual
CAROL BURZON GALICIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
3919 W JEFFERSON BLVD STE 2, FORT WAYNE, IN 46804-6811
(260) 436-7722
(260) 459-0012
Mailing address
3919 W JEFFERSON BLVD STE 2, FORT WAYNE, IN 46804-6811
(260) 436-7722
(260) 459-0012
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10004703A
IN
Other
Enumeration date
01/08/2025
Last updated
01/08/2025
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