Individual
CORY BANASCHAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2325 18TH ST STE 220, COLUMBUS, IN 47201-5389
(812) 376-5640
Mailing address
PO BOX 775383, CHICAGO, IL 60677-5383
(812) 376-5315
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
02006100A
IN
Other
Enumeration date
03/25/2017
Last updated
09/06/2024
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