Individual
MRS. THERESA ANN ELIAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11750 COMMERCIAL DR, T-1350, FISHERS, IN 46038-2903
(317) 845-4962
Mailing address
11750 COMMERCIAL DR, T-1350, FISHERS, IN 46038-2903
(317) 845-4962
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
26016491A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
26016491A
—
IN
Enumeration date
07/06/2012
Last updated
07/06/2012
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