| Ican | |
|
409 E Cook Rd Suite 100 Fort Wayne IN 46825-3600 | |
| (260) 498-9933 | |
| Not Available |
| Full Name | Ican |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 409 E Cook Rd, Fort Wayne, Indiana |
| Authorized Official Name and Position | Marla Jean Souder (PRESIDENT/COO) |
| Authorized Official Contact | 2604989933 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ican 2599 County Road 72 Auburn IN 46706-9624 Ph: (260) 498-9933 | Ican 409 E Cook Rd Suite 100 Fort Wayne IN 46825-3600 Ph: (260) 498-9933 |
| NPI Number | 1336579754 |
|---|---|
| Provider Enumeration Date | 11/21/2013 |
| Last Update Date | 11/21/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336579754 | NPI | - | NPPES |
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