Individual
SARA ANN BAYAN GROSSNIKLAUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
219 E 7TH ST APT 210, BLOOMINGTON, IN 47408-3577
(317) 407-0673
Mailing address
10981 WINDJAMMER DR N, INDIANAPOLIS, IN 46256-9672
(317) 407-0673
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
06/24/2024
Last updated
06/24/2024
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