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1215517438
JOHN WILLIAM FANTA
INDIANAPOLIS, IN
NPI
1215517438
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2021-04-12
Last Update Date
2021-04-12
Business Address
JOHN WILLIAM FANTA
1120 W MICHIGAN ST # CL642
INDIANAPOLIS, IN 46202-5209
Phone number: 317-278-2686
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Mailing Address
JOHN WILLIAM FANTA
1120 W MICHIGAN ST # CL642
INDIANAPOLIS, IN 46202-5209
Phone number: 317-278-2686
Copy
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