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Organization
WHITE RIVER DEVELOPMENT GROUP, INC.
Active
Organization
WHITE RIVER DEVELOPMENT GROUP, INC.
Active
Other names
The Complementary Medicine Center
Organization subpart
No
Provider details
NPI number
Authorized official
SUSIE ANDERSON (PRACTICE MANAGER)
(317) 885-3677
Entity
Organization
Contact information
Practice address
1250 E COUNTY LINE RD, SUITE 2, INDIANAPOLIS, IN 46227-1004
(317) 885-3677
(317) 885-3678
Mailing address
1250 E COUNTY LINE RD, SUITE 2, INDIANAPOLIS, IN 46227-1004
(317) 885-3677
(317) 885-3678
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71000465A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
595590HHH
MEDICARE ID
IN
01
—
71000465
LICENSE
IN
Enumeration date
02/19/2008
Last updated
02/19/2008
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