Individual
MIRANDA DOTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5420 PICKAWILLANY CT, FORT WAYNE, IN 46835-7703
(260) 760-1541
Mailing address
5420 PICKAWILLANY CT, FORT WAYNE, IN 46835-7703
(260) 760-1541
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/02/2025
Last updated
04/02/2025
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