Individual
NICOLE ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3320 N CLINTON ST, FORT WAYNE, IN 46805-1918
(260) 483-2100
Mailing address
7924 WILDBERRY LN, FORT WAYNE, IN 46815-8083
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05015091A
IN
Other
Enumeration date
06/12/2023
Last updated
09/12/2024
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