RUSSELL JOHN WAREHAM

INDIANAPOLIS, IN
NPI1619717816
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy225200000X Physical Therapy Assistant
(Licence: IN  06002776A)
Enumeration Date2024-05-28
Last Update Date2024-05-28
Business Address
RUSSELL JOHN WAREHAM PTA
6002 E 38TH ST
INDIANAPOLIS, IN 46226-5614
Phone number: 317-880-0280
Mailing Address
RUSSELL JOHN WAREHAM PTA
720 ESKENAZI AVE
INDIANAPOLIS, IN 46202-5187
Phone number: 317-880-0280
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