Individual
RAPHAEL FREDRICK FORESTIERI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
L.AC.
Contact information
Practice address
487 E DUPONT RD, FORT WAYNE, IN 46825-2051
(260) 637-6757
Mailing address
2307 FOREST PARK BLVD, FORT WAYNE, IN 46805-3618
(260) 797-1223
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
84000156A
IN
Other
Enumeration date
05/30/2013
Last updated
05/30/2013
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