Individual
ETHAN A DALY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4720 KINGSWAY DR, STE 400, INDIANAPOLIS, IN 46205-1555
(317) 472-7903
Mailing address
6950 HILLSDALE CT, INDIANAPOLIS, IN 46250-2040
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
10/05/2006
Last updated
07/08/2007
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