Organization
PATIENT CARE SERVICES TEAM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL HOLLIS (OWNER)
(317) 744-5368
Entity
Organization
Contact information
Practice address
939 CONNER ST STE 200, NOBLESVILLE, IN 46060-2622
(317) 219-7588
Mailing address
10505 HAWKS RIDGE CT, FISHERS, IN 46037-9258
(317) 730-4910
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
—
—
213EP1101X
Primary Podiatric Medicine Podiatrist
—
—
363LG0600X
Gerontology Nurse Practitioner
Primary
—
—
Other
Enumeration date
04/25/2014
Last updated
08/30/2019
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