Individual
RILEY ERIN BURNSIDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3400 BROADWAY, GARY, IN 46408-1101
(219) 980-6770
Mailing address
1139 SPANN AVE, INDIANAPOLIS, IN 46203-1145
(317) 709-1977
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
06/24/2024
Last updated
06/24/2024
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