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Organization
QHG OF FORT WAYNE COMPANY LLC
Active
Organization
QHG OF FORT WAYNE COMPANY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTINA MUSIC (DIRECTOR, PROVIDER ENROLLMENT)
(615) 465-7377
Entity
Organization
Contact information
Practice address
7333 W JEFFERSON BLVD, FORT WAYNE, IN 46804-6280
(260) 458-3843
(260) 637-1601
Mailing address
PO BOX 689022, FRANKLIN, TN 37068-9022
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
225100000X
Physical Therapist
—
—
Other
Enumeration date
06/08/2006
Last updated
10/01/2024
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