Individual
LETHA LOUISE TETRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
8101 CLEARVISTA PKWY, SUITE 185, INDIANAPOLIS, IN 46256-4696
(317) 621-9000
(317) 621-9194
Mailing address
8101 CLEARVISTA PKWY, SUITE 185, INDIANAPOLIS, IN 46256-4696
(317) 621-9000
(317) 621-9194
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
1036127
IN
208000000X
Pediatrics Physician
Primary
1036127
IN
Other
Enumeration date
05/19/2006
Last updated
01/29/2020
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