Individual
RYAN BACA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2010 N CAPITOL AVE, INDIANAPOLIS, IN 46202-1222
(317) 924-5821
Mailing address
1002 BURGESS HILL PASS, WESTFIELD, IN 46074-5882
(630) 531-4880
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
31006279A
IN
Other
Enumeration date
09/20/2018
Last updated
09/20/2018
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