PROVIDENCE MEDICAL ASSOCIATES LLC

INDIANAPOLIS, IN
NPI1326654070
Entity TypeOrganization
Authorized ContactOLUFUNKE LOUISE BRIMMO-LONGE
Owner
716-686-2104
Organization Subpart ?No
Primary Taxonomy261QM2500X Clinic/Center, Medical Specialty
Enumeration Date2020-09-18
Last Update Date2020-10-22
Business Address
PROVIDENCE MEDICAL ASSOCIATES LLC
1935 N CAPITOL AVE STE 107
INDIANAPOLIS, IN 46202-6403
Phone number: 716-686-2104
Mailing Address
PROVIDENCE MEDICAL ASSOCIATES LLC
4000 W 106TH ST STE 125-207
CARMEL, IN 46032-7720
Phone number:
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