Individual
EMANUEL LUCIAN BOAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
3630 ILLINOIS RD, FORT WAYNE, IN 46804-2062
(260) 255-6494
(260) 399-2075
Mailing address
3630 ILLINOIS RD, FORT WAYNE, IN 46804-2062
(260) 255-6494
(260) 399-2075
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
99094140A
IN
Other
Enumeration date
07/08/2019
Last updated
08/18/2023
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