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Individual

THERESE A BRAASCH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
ACUPUNCTURIST

Contact information

Practice address
601 E DUPONT RD, FORT WAYNE, IN 46825-2055
(260) 413-7160
Mailing address
6821 WOODCREST DR., FORT WAYNE, IN 46815
(260) 485-1879

Taxonomy

Speciality
Code
Description
License number
State
171100000X
Acupuncturist
84000105A
IN
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
26017081A
IN

Other

Enumeration date
09/30/2008
Last updated
02/06/2020
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