Individual
JACQUELYN BREWER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9645 WESTFIELD BLVD, INDIANAPOLIS, IN 46280-1771
(317) 801-4035
Mailing address
9645 WESTFIELD BLVD, INDIANAPOLIS, IN 46280-1771
(317) 801-4035
Taxonomy
Speciality
Code
Description
License number
State
347C00000X
Private Vehicle
Primary
—
—
Other
Enumeration date
10/13/2016
Last updated
10/13/2016
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