Organization
FATSAL SPECTACLE LLC
Active
Other names
FATSAL SPECTACLE LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BOLAJI SALAHUDEEN IMAM MD (MANAGING DIRECTOR)
(317) 222-0274
Entity
Organization
Contact information
Practice address
2835 POINTE BAY RD # 46229, INDIANAPOLIS, IN 46229-0003
(317) 222-0274
Mailing address
2835 POINTE BAY RD # 46229, INDIANAPOLIS, IN 46229-0003
(317) 222-0274
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Enumeration date
07/13/2024
Last updated
07/13/2024
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