Individual
OLIVER BIDWELL HALTHON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2001 W 86TH ST, INDIANAPOLIS, IN 46260-1902
(228) 324-7948
Mailing address
3707 SCOVEL AVE, PASCAGOULA, MS 39581-2853
(228) 324-7948
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
31008426A
IN
Other
Enumeration date
08/06/2024
Last updated
08/06/2024
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