Individual
MATT LANSING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2028 RIVER RUN TRL APT A, FORT WAYNE, IN 46825-6084
(541) 761-6621
Mailing address
2028 RIVER RUN TRL APT A, FORT WAYNE, IN 46825-6084
(541) 761-6621
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
06/26/2024
Last updated
06/26/2024
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