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4500 Dan Patch Cir Anderson IN 46013-3165 | |
| (765) 609-4711 | |
| (765) 609-4713 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 4500 Dan Patch Cir, Anderson, Indiana |
| Authorized Official Name and Position | Jon Leizman (PRESIDENT) |
| Authorized Official Contact | 6154686270 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
5500 Maryland Way Ste 120 Brentwood TN 37027-4993 Ph: () - | 4500 Dan Patch Cir Anderson IN 46013-3165 Ph: (765) 609-4711 |
| NPI Number | 1114588233 |
|---|---|
| Provider Enumeration Date | 06/28/2019 |
| Last Update Date | 10/29/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114588233 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
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