Individual
JENNA MARIE ROY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1007 W RUDISILL BLVD STE B101, FORT WAYNE, IN 46807-2171
(260) 425-5180
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10003270A
IN
363A00000X
Physician Assistant
—
—
Other
Enumeration date
03/11/2021
Last updated
10/17/2022
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