Individual
AMBER DAWN TRUMP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSPT, CLT-LANA
Contact information
Practice address
411 S WHITLOCK ST, BREMEN, IN 46506-1626
(574) 546-1930
Mailing address
PO BOX 1550, PORTAGE, IN 46368-9350
(888) 434-2314
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
05008322A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000215756
ANTHEM PIN NUMBER
IN
Enumeration date
07/21/2005
Last updated
09/03/2008
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