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Individual

DAVE CURTIS PHONDO SR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
1805 REVERE PL, CARMEL, IN 46032-2937
(317) 853-6633
Mailing address
1805 REVERE PL, CARMEL, IN 46032-2937

Taxonomy

Speciality
Code
Description
License number
State
347C00000X
Private Vehicle
Primary
347C00000X
IN
347C00000X
Private Vehicle

Other

Enumeration date
06/26/2012
Last updated
06/26/2012
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