Individual
MRS. MIRIAM ELIZABETH SMALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1700 E 38TH ST, MARION, IN 46953-4568
(765) 674-3321
(765) 677-6198
Mailing address
290 E MAIN ST, WABASH, IN 46992-2811
(765) 618-7374
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
28184358A
IN
Other
Enumeration date
06/03/2022
Last updated
06/03/2022
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