Organization
CENTRAL INDIANA ALLERGY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ANGELA RAY (MANAGER)
(317) 865-0055
Entity
Organization
Contact information
Practice address
965 EMERSON PKWY STE B, GREENWOOD, IN 46143-6274
(317) 865-0055
(317) 865-0056
Mailing address
965 EMERSON PKWY STE B, GREENWOOD, IN 46143-6274
(317) 865-0055
(317) 865-0056
Taxonomy
Speciality
Code
Description
License number
State
207KA0200X
Allergy Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200917240
—
IN
Enumeration date
08/05/2009
Last updated
09/28/2020
Update your record
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