Organization
THREE RIVERS DERMATOLOGY, LLC
Active
Other names
Three Rivers Dermatology
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFFREY WALTER SASSMANNSHAUSEN M.D. (CEO/OWNER)
(260) 436-9696
Entity
Organization
Contact information
Practice address
5650 COVENTRY LN, FORT WAYNE, IN 46804-7140
(260) 436-9696
(260) 436-9424
Mailing address
5650 COVENTRY LN, FORT WAYNE, IN 46804-7140
(260) 436-9696
(260) 436-9424
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
09/19/2007
Last updated
06/12/2020
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