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Individual

GEDION MAMO ADMASSU

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
309 SPRING FOREST CT, FORT WAYNE, IN 46804-6723
(260) 304-7144
Mailing address
309 SPRING FOREST CT, FORT WAYNE, IN 46804-6723
(260) 304-7144

Taxonomy

Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
9371686423
IN

Other

Enumeration date
04/01/2026
Last updated
04/01/2026
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