Organization
CENTRAL INDIANA ORTHOPEDICS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. VICTOR MORAN (CEO)
(765) 284-7738
Entity
Organization
Contact information
Practice address
3600 W BETHEL AVE, MUNCIE, IN 47304-5407
(765) 284-7738
Mailing address
PO BOX 1643, MUNCIE, IN 47308-1643
(765) 284-7738
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
36000201A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
119302629
NATA CERTIFICATION
IN
01
—
36000201A
AT LICENSURE
IN
Enumeration date
12/18/2006
Last updated
11/29/2022
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