Individual
MRS. BRENDA A PALM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
10305 DAWSONS CREEK BLVD, STE F, FORT WAYNE, IN 46825-1914
(260) 497-0328
(260) 497-0904
Mailing address
10305 DAWSONS CREEK BLVD, STE F, FORT WAYNE, IN 46825-1914
(260) 497-0328
(260) 497-0904
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
31003508A
IN
Other
Enumeration date
09/22/2006
Last updated
07/08/2007
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