Individual
QYSHANDRA LYSHEA REXROAT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPHT
Contact information
Practice address
2726 ETHEL AVE, INDIANAPOLIS, IN 46208-5160
(463) 212-2160
Mailing address
2726 ETHEL AVE, INDIANAPOLIS, IN 46208-5160
(463) 212-2160
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
67020716A
IN
Other
Enumeration date
07/07/2022
Last updated
07/07/2022
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