Individual
ANTHONY B CENTLIVRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
201 E RUDISILL BLVD, FORT WAYNE, IN 46806-1738
(888) 470-0082
Mailing address
2621 E JEFFERSON ST, WARSAW, IN 46580-3880
(574) 267-7169
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
71012957A
IN
Other
Enumeration date
08/31/2022
Last updated
08/31/2022
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