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Organization

FRESH START RECOVERY GROUP LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
EAMON CHRISTOPHER POOR (OFFICE MANAGER)
(260) 402-1503
Entity
Organization

Contact information

Practice address
3464 STELLHORN RD, FORT WAYNE, IN 46815-4630
(260) 402-9145
Mailing address
11788 WHISTLING TRL, FORT WAYNE, IN 46818-0144
(260) 402-1503

Taxonomy

Speciality
Code
Description
License number
State
207QA0401X
Addiction Medicine (Family Medicine) Physician
Primary

Other

Enumeration date
01/25/2023
Last updated
01/25/2023
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