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1912348210
NICHOLAS RAY TJEERDSMA
FORT WAYNE, IN
NPI
1912348210
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
Enumeration Date
2013-07-15
Last Update Date
2018-01-05
Business Address
Mr. NICHOLAS RAY TJEERDSMA ATC
3946 ICE WAY
FORT WAYNE, IN 46808-1735
Phone number: 319-939-7102
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Mailing Address
Mr. NICHOLAS RAY TJEERDSMA ATC
3946 ICE WAY
FORT WAYNE, IN 46808
Phone number: 319-939-7102
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