Individual
MS. CONNIE J LUBBEHUSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
920 E COLISEUM BLVD, FORT WAYNE, IN 46805-1329
(260) 498-8077
Mailing address
920 E COLISEUM BLVD, FORT WAYNE, IN 46805-1329
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10000811A
IN
Other
Enumeration date
11/20/2006
Last updated
03/03/2016
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