Individual
BRICE R HASTINGS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
11109 PARKVIEW PLAZA DR, FORT WAYNE, IN 46845-1701
(419) 490-5552
Mailing address
608 UNION CHAPEL RD, FORT WAYNE, IN 46845-9357
(419) 490-5552
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10002432A
IN
363A00000X
Physician Assistant
—
OH
Other
Enumeration date
01/18/2018
Last updated
06/19/2024
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