Individual
DANIEL T FIDLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2040 S WESTERN AVE, MARION, IN 46953-2823
(765) 673-4327
Mailing address
2040 S WESTERN AVE, MARION, IN 46953-2823
(765) 673-4327
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
17001244A
IN
Other
Enumeration date
01/29/2021
Last updated
01/29/2021
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