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1164425187
BRIAN T LAURSEN
FORT WAYNE, IN
NPI
1164425187
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: IN 10000668A)
Enumeration Date
2005-05-23
Last Update Date
2023-09-19
Business Address
BRIAN T LAURSEN P.A.
7601 W JEFFERSON BLVD
FORT WAYNE, IN 46804-4133
Phone number: 260-436-8686
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Mailing Address
BRIAN T LAURSEN P.A.
PO BOX 2526
FORT WAYNE, IN 46801-2526
Phone number: 260-436-8686
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