| NPI | 1992991475 |
|---|---|
| Doing Business As | THREE RIVERS DERMATOLOGY |
| Entity Type | Organization |
| Authorized Contact | JEFFREY WALTER SASSMANNSHAUSEN CEO/Owner 260-436-9696 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist |
| Enumeration Date | 2007-09-19 |
| Last Update Date | 2020-06-12 |