| Davis Mintun Professional Services Inc | |
|
6801 Lake Plaza Dr Ste A102 Indianapolis IN 46220-4061 | |
| (317) 578-2122 | |
| (317) 578-3655 |
| Full Name | Davis Mintun Professional Services Inc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 6801 Lake Plaza Dr, Indianapolis, Indiana |
| Authorized Official Name and Position | Thomas Garth Mintun (VICE PRESIDENT) |
| Authorized Official Contact | 3175782122 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Davis Mintun Professional Services Inc 6801 Lake Plaza Dr Ste A102 Indianapolis IN 46220-4061 Ph: (317) 578-2122 | Davis Mintun Professional Services Inc 6801 Lake Plaza Dr Ste A102 Indianapolis IN 46220-4061 Ph: (317) 578-2122 |
| NPI Number | 1518401868 |
|---|---|
| Provider Enumeration Date | 12/06/2016 |
| Last Update Date | 12/06/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518401868 | NPI | - | NPPES |
| 1497794572 | Other | IN | INDIVIDUAL NPI NUMBER FOR THOMAS GARTH MINTUN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 34001376A (Indiana) | Primary |
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