Individual
CORY LEE FORNAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
11130 PARKVIEW CIRCLE DR, FORT WAYNE, IN 46845
(260) 266-6221
(260) 458-5733
Mailing address
11130 PARKVIEW CIRCLE DR, FORT WAYNE, IN 46845-1735
(260) 266-6221
(260) 458-5733
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05011468A
IN
Other
Enumeration date
09/03/2014
Last updated
12/03/2019
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