Individual
EILISH MARY ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
201 PENNSYLVANIA PKWY STE 100, INDIANAPOLIS, IN 46280-1393
(317) 817-1200
Mailing address
201 PENNSYLVANIA PKWY STE 100, INDIANAPOLIS, IN 46280-1393
(317) 817-1200
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
096.003993
IL
2255A2300X
Athletic Trainer
Primary
36003061A
IN
Other
Enumeration date
12/01/2015
Last updated
10/22/2018
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