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1902842677
ZACHRY LANE WATERSON
FORT WAYNE, IN
NPI
1902842677
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207Q00000X Family Medicine
(Licence: IN 0200245A)
Enumeration Date
2006-06-21
Last Update Date
2011-06-03
Business Address
-- ZACHRY LANE WATERSON DO
750 BROADWAY SUITE 350
FORT WAYNE, IN 46802-1411
Phone number: 260-423-2682
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Mailing Address
-- ZACHRY LANE WATERSON DO
750 BROADWAY SUITE 150
FORT WAYNE, IN 46802-1411
Phone number: 260-423-2682
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