Individual
WALTER LITZLBAUER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
338 N HOLMES AVE, INDIANAPOLIS, IN 46222-3702
(317) 602-8046
Mailing address
338 N HOLMES AVE, INDIANAPOLIS, IN 46222-3702
(317) 602-8046
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
0920283760
IN
Other
Enumeration date
03/17/2014
Last updated
03/17/2014
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