Individual
AVERY VORNDRAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
4606 W JEFFERSON BLVD, FORT WAYNE, IN 46804-6826
(260) 459-1111
Mailing address
4606 W JEFFERSON BLVD, FORT WAYNE, IN 46804-6826
(260) 459-1111
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Enumeration date
12/08/2020
Last updated
12/08/2020
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