Individual
LETHA TETRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
7910 E WASHINGTON ST STE 200, INDIANAPOLIS, IN 46219-5563
(317) 355-7171
Mailing address
6626 E 75TH ST, STE 500, INDIANAPOLIS, IN 46250-2805
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
02005720A
IN
390200000X
Student in an Organized Health Care Education/Training Program
11019540A
IN
Other
Enumeration date
04/27/2017
Last updated
12/16/2024
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