Organization
PEOPLE OF CONVICTION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SAHARRA L BLEDSOE (EXE DIRECTOR)
(260) 424-3420
Entity
Organization
Contact information
Practice address
1325 S ANTHONY BLVD, FORT WAYNE, IN 46803-2107
(260) 424-3420
(260) 424-3420
Mailing address
1325 S ANTHONY BLVD, FORT WAYNE, IN 46803-2107
(260) 424-3420
(260) 424-3420
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
—
—
Other
Enumeration date
03/12/2007
Last updated
08/22/2020
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