Barasa, Boaz Nyongesa

Barasa, Boaz Nyongesa is an individual health care provider with primary practice located at 17475 Dugdale Dr , South Bend IN 46635-1545. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant, which is considered as his primary health care specialty. Barasa, Boaz Nyongesa can be contacted via phone (574) 247-7500.

Contact Information

Primary practice address
17475 Dugdale Dr South Bend IN 46635-1545
Phone: (574) 247-7500
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant 225200000X 06005605A Indiana

Profile Details

NPI number 1427698307
LBN Legal business name Barasa, Boaz Nyongesa
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 8th, 2020
Last updated Jan 8th, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1427698307 NPPES
Indiana Other 0 N/A

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