Individual
MRS. LAINE ELAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
2525 W UNIVERSITY AVE STE 402, MUNCIE, IN 47303-3409
(765) 747-6090
(765) 747-5069
Mailing address
3500 W PURDUE AVE, MUNCIE, IN 47304-6357
(765) 747-6090
(765) 747-5069
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10000270A
IN
Other
Enumeration date
10/24/2006
Last updated
10/16/2017
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