Three Rivers Dermatology, LLC

NPI #1992991475 in Fort Wayne, Indiana

Provider Information

NPI Number: 1992991475
Entity Type: Organization
Organization Name: Three Rivers Dermatology, LLC
Primary Specialty: Specialist
Enumeration Date: Sep 19, 2007
Last Updated: Jun 12, 2020

Practice Location

Address: 5650 COVENTRY LN
City: Fort Wayne
State: Indiana
ZIP Code: 46804-7140
Phone: (260) 436-9696

Authorized Official

Name: DR. JEFFREY WALTER SASSMANNSHAUSEN, M.D.
Title: CEO/OWNER
Phone: (260) 436-9696

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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