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Individual

MARIO ANDROLIS YOUNG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
C.O.T.A.

Contact information

Practice address
1001 N GRANT ST, LEBANON, IN 46052-1944
(765) 482-6400
Mailing address
4322 WINTHROP AVE, INDIANAPOLIS, IN 46205-1972
(317) 283-7742

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
32000023A
IN

Other

Enumeration date
07/16/2008
Last updated
07/16/2008
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