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1205828001
JASON P KNISELY
FORT WAYNE, IN
NPI
1205828001
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: IN 10000501A)
Enumeration Date
2005-08-17
Last Update Date
2018-10-30
Business Address
JASON P KNISELY PA
5050 N CLINTON ST
FORT WAYNE, IN 46825-5886
Phone number: 260-484-8551
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Mailing Address
JASON P KNISELY PA
5052 N CLINTON ST
FORT WAYNE, IN 46825-5822
Phone number: 260-484-8551
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