JORDAN TYLER LAKES

INDIANAPOLIS, IN
NPI1962856104
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy172V00000X Community Health Worker
(Licence: IN  31006064A)
Enumeration Date2016-04-13
Last Update Date2016-04-13
Business Address
-- JORDAN TYLER LAKES MSOT
9190 PRIORITY WAY WEST DR
INDIANAPOLIS, IN 46240-6426
Phone number: 317-805-4963
Mailing Address
-- JORDAN TYLER LAKES MSOT
9190 PRIORITY WAY WEST DR
INDIANAPOLIS, IN 46240-6426
Phone number: 317-805-4963
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