Individual
PRAVEENA MALLIKA KANTETI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
20 S MORTON ST, FRANKLIN, IN 46131-2102
(317) 736-8089
Mailing address
6041 PRAIRIE STREAM WAY, COLUMBUS, IN 47203-9050
(248) 844-9305
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
26023020A
IN
Other
Enumeration date
09/30/2011
Last updated
09/30/2011
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