Individual
EMMERSON DUO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6138 GLEBE DR, INDIANAPOLIS, IN 46237-9038
(217) 721-2860
Mailing address
6138 GLEBE DR, INDIANAPOLIS, IN 46237-9038
(217) 721-2860
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
IN
Other
Enumeration date
11/28/2016
Last updated
11/28/2016
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