Organization
PREMISE HEALTH OF INDIANA MEDICAL, PC
Active
Organization
PREMISE HEALTH OF INDIANA MEDICAL, PC
Active
Other names
adidas Indianapolis Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN LEIZMAN MD (PRESIDENT)
(615) 468-6270
Entity
Organization
Contact information
Practice address
8677 IMPACT CT, INDIANAPOLIS, IN 46219-1424
(371) 895-7173
Mailing address
5500 MARYLAND WAY STE 120, BRENTWOOD, TN 37027-4993
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
10/17/2023
Last updated
10/17/2023
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