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1275877201
JERRY DONNELL FORD
FORT WAYNE, IN
NPI
1275877201
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: IN 36001580A)
Enumeration Date
2012-11-15
Last Update Date
2012-11-15
Business Address
-- JERRY DONNELL FORD ATC
4251 LAHMEYER RD
FORT WAYNE, IN 46815-5676
Phone number: 260-432-4700
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Mailing Address
-- JERRY DONNELL FORD ATC
4251 LAHMEYER RD
FORT WAYNE, IN 46815-5676
Phone number: 260-432-4700
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