NPI
LastName
FirstName
MidName
Organization
Mailing Address
City
State
Zip
1265410120
MANALO
EDNA
M
6920 POINTE INVERNESS WAY STE 200
FORT WAYNE
IN
468047934
1083605364
MANALO
MANOLO
M.
6920 POINTE INVERNESS WAY STE 200
FORT WAYNE
IN
468047934
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