NATHANIEL D ROACH

FORT WAYNE, IN
NPI1841421583
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363AM0700X Physician Assistant, Medical
(Licence: IN  10001124A)
Enumeration Date2009-07-29
Last Update Date2018-10-23
Business Address
NATHANIEL D ROACH PA
5050 N CLINTON ST
FORT WAYNE, IN 46825-5886
Phone number: 260-484-8551
Mailing Address
NATHANIEL D ROACH PA
5052 N CLINTON ST
FORT WAYNE, IN 46825-5822
Phone number: 260-484-8551
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