Individual
TONDA R FANDRICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LDH
Contact information
Practice address
4930 PEMBRIDGE DR, INDIANAPOLIS, IN 46254-4890
(317) 552-5764
Mailing address
4930 PEMBRIDGE DR, INDIANAPOLIS, IN 46254-4890
(317) 552-5764
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
13004891A
IN
Other
Enumeration date
03/21/2022
Last updated
03/21/2022
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