JOHANNA HENDERSON WALLISA

INDIANAPOLIS, IN
NPI1932357407
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy207L00000X Anesthesiology
(Licence: IN  01063488A)
Enumeration Date2008-09-08
Last Update Date2008-09-08
Business Address
-- JOHANNA HENDERSON WALLISA MD
702 BARNHILL DR ROOM 2001
INDIANAPOLIS, IN 46202-5128
Phone number: 317-274-9981
Mailing Address
-- JOHANNA HENDERSON WALLISA MD
4809 MELBOURNE RD
INDIANAPOLIS, IN 46228-2090
Phone number: 317-985-5894
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