JACQUELYN GERALDINE SMALL

FORT WAYNE, IN
NPI1225694102
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy207Q00000X Family Medicine
(Licence: IN  02007766A)
Additional Taxonomies207Q00000X Family Medicine
(Licence: MI  5101025847)
Enumeration Date2019-05-15
Last Update Date2024-09-03
Business Address
Dr. JACQUELYN GERALDINE SMALL DO
3909 NEW VISION DR
FORT WAYNE, IN 46845-1725
Phone number: 260-469-6610
Mailing Address
Dr. JACQUELYN GERALDINE SMALL DO
11109 PARKVIEW PLAZA DR # 117
FORT WAYNE, IN 46845-1701
Phone number:
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