NPI 1114364254

Raphael Fredrick Forestieri, LAC

Practitioner Acupuncturist Fort Wayne, IN

Practice location

Address: 487 E Dupont Rd, Fort Wayne, IN 46825-2051
Phone: (260) 637-6757
Mailing address: 2307 Forest Park Blvd, Fort Wayne, IN 46805-3618

Registered specialties

Acupuncturist Primary

Other Service Providers Taxonomy 171100000X Licence 84000156A (IN)

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Registry record

NPI: 1114364254
Entity type: Individual
Sex (as registered): Male
NPI issued: 30 May 2013
Record last updated: 30 May 2013

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.