NPI 1023724861
Fresh Start Recovery Group LLC
Practice location
- Address
- 3464 Stellhorn Rd, Fort Wayne, IN 46815-4630
- Phone
- (260) 402-9145
- Mailing address
- 11788 Whistling Trl, Fort Wayne, IN 46818-0144
Authorised official
- Name
- Eamon Christopher Poor
- Title
- Office Manager
- Phone
- (260) 402-1503
Registered specialties
Addiction Medicine (Family Medicine) Physician
Primary
Registry record
- NPI
- 1023724861
- Entity type
- Organization
- NPI issued
- 25 Jan 2023
- Record last updated
- 25 Jan 2023
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.