Individual
MRS. STARR ANGELINE SONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2819 EMBASSY ROW, 819, INDIANAPOLIS, IN 46224
(317) 400-7545
Mailing address
2819 EMBASSY ROW, 819, INDIANAPOLIS, IN 46224-2988
(317) 400-7545
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
2350-43-7769
IN
172A00000X
Driver
Primary
2350-43-7769
IN
Other
Enumeration date
08/09/2011
Last updated
08/09/2011
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