Individual
GERARDO DAVID RESTO SANTOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
950 W WALNUT ST, INDIANAPOLIS, IN 46202-5188
(317) 278-6061
Mailing address
26 W WASHINGTON ST APT 303, INDIANAPOLIS, IN 46204-3439
(787) 361-8397
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
11023909A
IN
390200000X
Student in an Organized Health Care Education/Training Program
6043032
PR
Other
Enumeration date
06/28/2019
Last updated
07/28/2024
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