Individual
EBONY GREENWADE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT, MMP
Contact information
Practice address
1060 E 86TH ST STE 61H, INDIANAPOLIS, IN 46240-1831
(317) 296-5348
Mailing address
2620 SICKLE RD, INDIANAPOLIS, IN 46219-1338
(317) 938-9028
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT21806682
IN
Other
Enumeration date
07/10/2023
Last updated
07/10/2023
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