Graduated: 1988
NPI: 1215939954
Practice Locations (4)
11109 PARKVIEW PLAZA DR MAILBOX, SUITE 117
Fort Wayne, IN 468451701
11109 PARKVIEW PLAZA DR
FORT WAYNE, IN 468451701
11109 PARKVIEW PLAZA DR, SUITE 117
FORT WAYNE, IN 468451701
11109 PARKVIEW PLAZA DR MAILBOX, SUITE 117
FORT WAYNE, IN 468451701
Source: CMS National Downloadable File, September 2026.