Organization
FORT WAYNE NEUROFEEDBACK, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CELESTE M ROCKWELL (C.A.)
(260) 432-8777
Entity
Organization
Contact information
Practice address
10910 US HIGHWAY 24 W, UNIT A, FORT WAYNE, IN 46814-8157
(260) 432-8777
Mailing address
7127 HOMESTEAD RD STE F, FORT WAYNE, IN 46814-4601
(260) 432-8777
(260) 432-8777
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
08000637A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100253370A
—
IN
Enumeration date
06/11/2007
Last updated
05/18/2020
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