JASON ALAN MAXWELL

FORT WAYNE, IN
NPI1023560638
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy225200000X Physical Therapy Assistant
(Licence: IN  06005269A)
Enumeration Date2016-10-30
Last Update Date2016-10-30
Business Address
-- JASON ALAN MAXWELL PTA
7525 MAPLECREST RD # 112
FORT WAYNE, IN 46835-1897
Phone number: 260-273-1206
Mailing Address
-- JASON ALAN MAXWELL PTA
7525 MAPLECREST RD # 112
FORT WAYNE, IN 46835-1897
Phone number: 260-273-1206
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