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1598533986
IRIS KETAMINE & INFUSIONS, LLC
FORT WAYNE, IN
NPI
1598533986
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Entity Type
Organization
Authorized Contact
SEAN GODDARD
Owner
866-218-5620
Organization Subpart ?
No
Primary Taxonomy
363L00000X Nurse Practitioner
Enumeration Date
2023-12-14
Last Update Date
2023-12-14
Business Address
IRIS KETAMINE & INFUSIONS, LLC
9025 COLDWATER RD STE 200
FORT WAYNE, IN 46825-2097
Phone number: 866-218-5620
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Mailing Address
IRIS KETAMINE & INFUSIONS, LLC
9025 COLDWATER RD STE 200
FORT WAYNE, IN 46825-2097
Phone number: 866-218-5620
Copy
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