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Organization

ATHELITE ORTHOPEDICS AND SPORTS MEDICINE, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DOUGLAS ALAN FLORY M.D. (MEMBER)
(812) 822-2675
Entity
Organization

Contact information

Practice address
365 S PARK RIDGE RD, SUITE 102, BLOOMINGTON, IN 47401-8361
(812) 822-2675
(812) 822-2679
Mailing address
365 S PARK RIDGE RD, SUITE 102, BLOOMINGTON, IN 47401-8361
(812) 822-2675
(812) 822-2679

Taxonomy

Speciality
Code
Description
License number
State
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
Primary
1052068
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200272920
IN
Enumeration date
01/06/2010
Last updated
01/06/2010
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