Individual
RONALD D FOWLKES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
8255 CRAIG ST STE 106, INDIANAPOLIS, IN 46250-4583
(260) 435-0130
Mailing address
8255 CRAIG ST STE 106, INDIANAPOLIS, IN 46250-4583
(260) 435-0130
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
25-018906-1
IN
Other
Enumeration date
04/22/2025
Last updated
04/22/2025
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