Individual
SHAUNA J DURHMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1211 FULTON ST, APT #1, FORT WAYNE, IN 46802-3321
(612) 270-0342
Mailing address
1211 FULTON ST, APT #1, FORT WAYNE, IN 46802-3321
(612) 270-0342
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
07192
NC
Other
Enumeration date
03/07/2008
Last updated
03/07/2008
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