Individual
MR. KIP SEIDENSTUCKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2323 E 58TH ST, INDIANAPOLIS, IN 46220-2816
(812) 230-5723
Mailing address
2323 E 58TH ST, INDIANAPOLIS, IN 46220-2816
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
32001440A
IN
Other
Enumeration date
02/10/2012
Last updated
02/10/2012
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