Organization
WOMEN'S HEALTH ADVANTAGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROGER E SPORRE MD (OWNER PARTNER)
(260) 432-4400
Entity
Organization
Contact information
Practice address
7635 W JEFFERSON BLVD, FORT WAYNE, IN 46804-4133
(260) 432-4400
Mailing address
2512 DUPONT ROAD, SUITE 200, FORT WAYNE, IN 46825
(260) 432-4400
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
04/27/2007
Last updated
08/22/2020
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