Organization
CLINIC AT HOME
Active
Organization
CLINIC AT HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MERCY MOTO NURSE PRACTITIONER (OWNER)
(732) 861-3749
Entity
Organization
Contact information
Practice address
14675 CHRISTIE ANN DR, FISHERS, IN 46040-9682
(732) 861-3749
Mailing address
14675 CHRISTIE ANN DR, FISHERS, IN 46040-9682
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
71004940A
IN
Other
Enumeration date
10/12/2015
Last updated
10/12/2015
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