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1114093390
RICHARD ALLAN KERESEY
INDIANAPOLIS, IN
NPI
1114093390
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: IN 10000012A)
Enumeration Date
2006-11-28
Last Update Date
2007-07-08
Business Address
Mr. RICHARD ALLAN KERESEY PAC
5603 W RAYMOND SUITE A
INDIANAPOLIS, IN 46241-4356
Phone number: 317-241-8266
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Mailing Address
Mr. RICHARD ALLAN KERESEY PAC
4850 W CENTURY PLAZA RD
INDIANAPOLIS, IN 46254
Phone number: 317-216-2828
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