Organization · Type 2 NPI
Legacy Treatment Center LLC
Addiction Medicine (Family Medicine) Physician · Fort Wayne, IN
NPI number
1336940717
Active
Practice location
3030 Lake Ave Ste 24
Fort Wayne, IN 46805-5428
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Addiction Medicine (Family Medicine) Physician Primary | 207QA0401X | None listed |
Addiction Medicine (Family Medicine) Physician: A family medicine physician who specializes in the diagnosis and treatment of addictions.
3 other providers at this address
Other addiction medicine (family medicine) physician providers in Fort Wayne
About NPI 1336940717
Legacy Treatment Center LLC's National Provider Identifier is 1336940717, issued on Mar 21, 2025. The primary taxonomy on file is Addiction Medicine (Family Medicine) Physician (207QA0401X), and the practice location is in Fort Wayne, IN. The record was last updated on Dec 12, 2025.