Individual
KYLIE ELIZABETH MARTINDALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
2610 ENTERPRISE DR, ANDERSON, IN 46013-9684
(800) 622-6575
Mailing address
1122 WAGGONER DR, RUSHVILLE, IN 46173-1060
Taxonomy
Speciality
Code
Description
License number
State
405300000X
Prevention Professional
Primary
36003006A
IN
Other
Enumeration date
06/16/2019
Last updated
06/16/2019
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