Individual
MR. IAN P MCDANIEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
6855 SHORE TERRACE DR., STE 100, INDIANAPOLIS, IN 46254
(317) 241-3200
(317) 241-2535
Mailing address
1781 E LINCOLN RD, KOKOMO, IN 46902-3993
(317) 241-3200
(317) 241-2535
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05007945A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000329344
BCBS
IN
01
—
5387109
AETNA
IN
Enumeration date
09/27/2006
Last updated
07/08/2007
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