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1558332403
TODD LEE DETURK
FORT WAYNE, IN
NPI
1558332403
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: IN 10000810A)
Enumeration Date
2006-01-30
Last Update Date
2016-11-07
Business Address
-- TODD LEE DETURK P.A.
7601 W JEFFERSON BLVD
FORT WAYNE, IN 46804-4133
Phone number: 260-436-8686
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Mailing Address
-- TODD LEE DETURK P.A.
PO BOX 2526
FORT WAYNE, IN 46801-2526
Phone number: 260-436-8686
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