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1386306231
INNISS M TARAWOLLIE
INDIANAPOLIS, IN
NPI
1386306231
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
335E00000X Prosthetic/Orthotic Supplier
(Licence: IN BC20501718)
Enumeration Date
2021-10-07
Last Update Date
2024-08-26
Business Address
INNISS M TARAWOLLIE
5108 W 38TH ST
INDIANAPOLIS, IN 46254-3326
Phone number: 317-760-7180
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Mailing Address
INNISS M TARAWOLLIE
5108 W 38TH ST
INDIANAPOLIS, IN 46254-3326
Phone number: 317-760-7180
Copy
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