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1104395680
REGEN MED OF INDIANA LLC
FORT WAYNE, IN
NPI
1104395680
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Entity Type
Organization
Authorized Contact
TONNA B. CHALFANT
Manager
260-482-2206
Organization Subpart ?
No
Primary Taxonomy
208D00000X General Practice
Enumeration Date
2018-11-14
Last Update Date
2018-11-14
Business Address
REGEN MED OF INDIANA LLC
5931 STONEY CREEK DR
FORT WAYNE, IN 46825-4401
Phone number: 260-482-2206
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Mailing Address
REGEN MED OF INDIANA LLC
5931 STONEY CREEK DR
FORT WAYNE, IN 46825-4401
Phone number: 260-482-2206
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