BOAZ NYONGESA BARASA

SOUTH BEND, IN
NPI1427698307
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy225200000X Physical Therapy Assistant
(Licence: IN  06005605A)
Enumeration Date2020-01-08
Last Update Date2020-01-08
Business Address
BOAZ NYONGESA BARASA
17475 DUGDALE DR
SOUTH BEND, IN 46635-1545
Phone number: 574-247-7500
Mailing Address
BOAZ NYONGESA BARASA
828 LIBERTY ST
ELKHART, IN 46514-2604
Phone number: 574-575-8824
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