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1255561767
ADAM UPDEGRAFF
FORT WAYNE, IN
NPI
1255561767
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207K00000X Allergy & Immunology
(Licence: IN 02005087A)
Enumeration Date
2009-07-17
Last Update Date
2018-09-18
Business Address
ADAM UPDEGRAFF DO
7964 W JEFFERSON BLVD
FORT WAYNE, IN 46804-4140
Phone number: 260-436-5670
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Mailing Address
ADAM UPDEGRAFF DO
7964 W JEFFERSON BLVD
FORT WAYNE, IN 46804-4140
Phone number: 260-436-5670
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