Individual
KATHERINE M SMALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
2605 N LEBANON ST, LEBANON, IN 46052-1476
(219) 241-6219
Mailing address
312 E 10TH ST, INDIANAPOLIS, IN 46202-3316
(219) 241-6219
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10001318A
IN
Other
Enumeration date
10/19/2011
Last updated
11/08/2012
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