Individual
MICHAEL ALLISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
2121 LAKE AVE, FORT WAYNE, IN 46805-5100
(260) 426-5431
Mailing address
2121 LAKE AVE, FORT WAYNE, IN 46805-5100
(260) 426-5431
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
28186083A
IN
Other
Enumeration date
06/01/2022
Last updated
06/01/2022
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