Organization
PREMISE HEALTH OF INDIANA MEDICAL, P.C.
Active
Other names
Family Health and Wellness Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JON LEIZMAN MD (PRESIDENT)
(216) 479-9063
Entity
Organization
Contact information
Practice address
1100 N LEBANON ST STE 2, JAMESTOWN, IN 46147-9381
(765) 577-5900
(765) 577-5932
Mailing address
5500 MARYLAND WAY STE 120, BRENTWOOD, TN 37027-4993
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
05/07/2021
Last updated
08/25/2022
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