Individual
MR. CHARLES MAURICE SURRETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
10608 NASSAU ST, INDIANAPOLIS, IN 46234-3183
(317) 250-1508
Mailing address
10608 NASSAU ST, INDIANAPOLIS, IN 46234-3183
(317) 250-1508
Taxonomy
Speciality
Code
Description
License number
State
373H00000X
Day Training/Habilitation Specialist
Primary
—
—
Other
Enumeration date
08/22/2018
Last updated
08/22/2018
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