Individual
JENNIFER RACICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
615 N 18TH ST, HOWARTH CENTER, SUITE 201, LAFAYETTE, IN 47904-3434
(765) 423-5361
Mailing address
3822 TIMOTHY TRL, LAFAYETTE, IN 47905-4928
(765) 543-2263
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
08/25/2011
Last updated
08/25/2011
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