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1114506433
JACK TIAHNYBIK
INDIANAPOLIS, IN
NPI
1114506433
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2021-04-05
Last Update Date
2021-04-05
Business Address
JACK TIAHNYBIK DO
1120 W MICHIGAN ST # CL642
INDIANAPOLIS, IN 46202-5209
Phone number: 317-278-2686
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Mailing Address
JACK TIAHNYBIK DO
1120 W MICHIGAN ST # CL642
INDIANAPOLIS, IN 46202-5209
Phone number:
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