Individual
DR. BRYANT LANE PONCHOT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
8258 ROCKVILLE RD, INDIANAPOLIS, IN 46214-3113
(317) 429-5400
(317) 429-5401
Mailing address
4625 S EMERSON AVE, INDIANAPOLIS, IN 46203-5972
(317) 522-2303
(317) 522-2304
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
08002296A
IN
Other
Enumeration date
09/26/2006
Last updated
04/15/2013
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