Individual
MRS. CAROLYN JEAN GUM
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
M.S.,P.T.
Contact information
Practice address
8724 SARGENT CREEK LN, INDIANAPOLIS, IN 46256-1376
(317) 913-0350
(317) 913-0351
Mailing address
8724 SARGENT CREEK LN, INDIANAPOLIS, IN 46256-1376
(317) 577-0763
(317) 913-0351
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05001785A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
352101298100
CARESOURCE
IN
Enumeration date
05/30/2006
Last updated
07/09/2007
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