Individual
MR. JON ANTHONY DESMARAIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
401 E COLFAX AVE, STE. 102, SOUTH BEND, IN 46617-2737
(574) 234-1059
(574) 234-1068
Mailing address
401 E COLFAX AVE, STE. 102, SOUTH BEND, IN 46617-2737
(574) 234-1059
(574) 234-1068
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05006317A
IN
Other
Enumeration date
12/16/2005
Last updated
10/05/2007
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