Individual
BRYCE DORSEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
7859 DANUBE ST, INDIANAPOLIS, IN 46239-9296
(317) 519-0085
Mailing address
7859 DANUBE ST, INDIANAPOLIS, IN 46239-9296
(317) 519-0085
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
Other
Enumeration date
06/12/2017
Last updated
07/21/2022
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