Individual
JULIA L BLANK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
4551 SYLVAN RD, INDIANAPOLIS, IN 46228-2846
(317) 329-8462
Mailing address
4551 SYLVAN RD, INDIANAPOLIS, IN 46228-2846
(317) 329-8462
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18003079A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200291140
—
IN
Enumeration date
10/21/2008
Last updated
10/21/2008
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