Individual
AUDRETTA DEANNE ATKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7883 SHAKER CT, FORT WAYNE, IN 46804-5708
(260) 573-7728
(855) 710-7995
Mailing address
7883 SHAKER CT, FORT WAYNE, IN 46804-5708
(260) 573-7728
(855) 710-7995
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
0500229390
IN
Other
Enumeration date
01/07/2020
Last updated
01/07/2020
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