THEPPANYA KA KEOLASY

ROANOKE, IN
NPI1124028881
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207Q00000X Family Medicine
(Licence: IN  01058795A)
Enumeration Date2005-07-26
Last Update Date2022-12-22
Business Address
THEPPANYA KA KEOLASY MD
577 GEIGER DR STE C
ROANOKE, IN 46783-8877
Phone number: 260-672-5950
Mailing Address
THEPPANYA KA KEOLASY MD
11109 PARKVIEW PLAZA DR # 117
FORT WAYNE, IN 46845-1701
Phone number:
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