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1750102083
ERIC ROBERT BLICKENSDERFER
INDIANAPOLIS, IN
NPI
1750102083
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2024-10-19
Last Update Date
2024-10-19
Business Address
Mr. ERIC ROBERT BLICKENSDERFER
1160 W MICHIGAN ST STE 100
INDIANAPOLIS, IN 46202-5209
Phone number: 574-855-0139
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Mailing Address
Mr. ERIC ROBERT BLICKENSDERFER
9373 BENCHMARK DR APT F
INDIANAPOLIS, IN 46240-4209
Phone number: 574-855-0139
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