| Gret Machlan Llc | |
|
2200 Lake Ave Ste 125 Fort Wayne IN 46805-5358 | |
| (260) 203-9059 | |
| (260) 444-2117 |
| Full Name | Gret Machlan Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 2200 Lake Ave Ste 125, Fort Wayne, Indiana |
| Authorized Official Name and Position | Margaret A Machlan (OWNER / CLINICIAN) |
| Authorized Official Contact | 2602039059 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gret Machlan Llc 2200 Lake Ave Suite 125 Fort Wayne IN 46805-5397 Ph: (260) 203-9059 | Gret Machlan Llc 2200 Lake Ave Ste 125 Fort Wayne IN 46805-5358 Ph: (260) 203-9059 |
| NPI Number | 1154747632 |
|---|---|
| Provider Enumeration Date | 03/08/2014 |
| Last Update Date | 04/18/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154747632 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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