Fundamental Health, INC

NPI #1114529237 in Lafayette, Indiana

Provider Information

NPI Number: 1114529237
Entity Type: Organization
Organization Name: Fundamental Health, INC
Primary Specialty: Internal Medicine
Enumeration Date: Nov 13, 2020
Last Updated: Feb 26, 2021

Practice Location

Address: 1221 S CREASY LN STE K3
City: Lafayette
State: Indiana
ZIP Code: 47905-7430
Phone: (765) 838-2310

Authorized Official

Name: MS. JULIE CHRISTINE MIRANDA, LPN
Title: PRACTICE MANAGER
Phone: (765) 838-2310

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Medical Specialty — Medical Specialty	261QM2500X
Internal Medicine	207R00000X	Primary

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