Individual
LISA R. CHUN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
3200 COLD SPRING RD, INDIANAPOLIS, IN 46222-1960
(317) 955-6296
Mailing address
6626 E 75TH ST, STE 500, INDIANAPOLIS, IN 46250-2805
Taxonomy
Speciality
Code
Description
License number
State
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
02004296A
IN
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
Primary
DOS 918
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201207980
—
IN
01
—
235572
HMSA LEGACY
—
01
—
P01424287
RAIL ROAD PTAN
IN
Enumeration date
11/25/2008
Last updated
04/14/2015
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