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1780396275
ALICIA ANNE BOOTH
FORT WAYNE, IN
NPI
1780396275
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Former Name
ALICIA ANNE SPEER
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
367H00000X Anesthesiologist Assistant
(Licence: IN 75000124A)
Enumeration Date
2022-12-16
Last Update Date
2024-05-20
Business Address
ALICIA ANNE BOOTH
11141 PARKVIEW PLAZA DR STE 200
FORT WAYNE, IN 46845-1714
Phone number: 260-425-6030
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Mailing Address
ALICIA ANNE BOOTH
11109 PARKVIEW PLAZA DR # 117
FORT WAYNE, IN 46845-1701
Phone number:
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