Individual
MS. DEMETRIA LYNETTE FLEMING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
8014 TACOMA PLACE, FORT WAYNE, IN 46835-9107
(804) 525-0212
Mailing address
8014 TACOMA PL, FORT WAYNE, IN 46835-9107
(804) 525-0212
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2000020821
IN
Other
Enumeration date
06/10/2015
Last updated
06/10/2015
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