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1040 E 86th St Suite 48-a Indianapolis IN 46240-1865 | |
| (317) 569-1800 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/center |
| Location | 1040 E 86th St, Indianapolis, Indiana |
| Authorized Official Name and Position | Linda Riccio (VICE PRESIDENT) |
| Authorized Official Contact | 3175040217 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1040 E 86th St Suite 48-a Indianapolis IN 46240-1865 Ph: (317) 569-1800 | 1040 E 86th St Suite 48-a Indianapolis IN 46240-1865 Ph: (317) 569-1800 |
| NPI Number | 1023426574 |
|---|---|
| Provider Enumeration Date | 07/29/2014 |
| Last Update Date | 07/29/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023426574 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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