Individual
DR. EVELYN ANTOINETTE DYSARZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
7117 N OLNEY ST, INDIANAPOLIS, IN 46240-3530
(317) 841-8664
Mailing address
7117 N OLNEY ST, INDIANAPOLIS, IN 46240-3530
(317) 841-8664
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
08001032
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000259060
ANTHEM
IN
05
—
200324090A
—
IN
Enumeration date
08/10/2005
Last updated
02/24/2010
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