JOHN WILLIAM FANTA

INDIANAPOLIS, IN
NPI1215517438
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy2084N0400X Psychiatry & Neurology, Neurology
(Licence: MI  4301513777)
Enumeration Date2021-04-12
Last Update Date2025-07-30
Business Address
JOHN WILLIAM FANTA
1120 W MICHIGAN ST # CL642
INDIANAPOLIS, IN 46202-5209
Phone number: 317-278-2686
Mailing Address
JOHN WILLIAM FANTA
1120 W MICHIGAN ST # CL642
INDIANAPOLIS, IN 46202-5209
Phone number: 317-278-2686
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