Individual
BETRIA MCCLOUD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
HLP
Contact information
Practice address
2508 E 146TH ST STE 107, CARMEL, IN 46033-7714
(317) 506-4390
Mailing address
7236 TWIN OAKS DR APT C, INDIANAPOLIS, IN 46226-5740
(317) 506-4390
Taxonomy
Speciality
Code
Description
License number
State
224P00000X
Prosthetist
Primary
CI21700032
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
85-0824374
IRS
—
Enumeration date
08/11/2020
Last updated
08/11/2020
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