Organization
GLO INK, LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DANI EVANS (OWNER)
(317) 667-2035
Entity
Organization
Contact information
Practice address
11801 COMMERCIAL DR, FISHERS, IN 46038-3110
(317) 676-9966
Mailing address
1705 FAIR WEATHER DR, PENDLETON, IN 46064-8598
(317) 667-2035
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
—
—
2255A2300X
Athletic Trainer
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01682288300
STATE LICENSING
IN
Enumeration date
10/17/2021
Last updated
10/17/2021
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