Individual
LAKIN DIETEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
8925 N MERIDIAN ST STE 200, INDIANAPOLIS, IN 46260-2385
(317) 660-4900
Mailing address
8925 N MERIDIAN ST STE 200, INDIANAPOLIS, IN 46260-2385
(317) 605-3842
(317) 660-4901
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
10002318A
IN
Other
Enumeration date
09/28/2017
Last updated
06/14/2021
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