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1265519185
PEDSTAT
FORT WAYNE, IN
NPI
1265519185
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Entity Type
Organization
Authorized Contact
GIRIDHAR RAO VEERULA
Owner
260-436-7722
Organization Subpart ?
No
Primary Taxonomy
261QU0200X Clinic/Center, Urgent Care
Enumeration Date
2006-11-01
Last Update Date
2007-09-07
Business Address
PEDSTAT
3919 W JEFFERSON BLVD SUITE 2
FORT WAYNE, IN 46804-6811
Phone number: 260-436-7722
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Mailing Address
PEDSTAT
3919 W JEFFERSON BLVD SUITE 2
FORT WAYNE, IN 46804-6811
Phone number: 260-436-7722
Copy
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