Individual
BRIAN BAZOON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
10291 N MERIDIAN ST STE 170, CARMEL, IN 46290-1000
(317) 973-0888
Mailing address
6574 CAPTIVA PASS, PLAINFIELD, IN 46168-8006
(317) 332-8477
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT22007219
IN
Other
Enumeration date
10/20/2020
Last updated
10/20/2020
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