Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 31000321A | IN |
NPI | 1043760291 |
---|---|
Provider Name | Alan Bunch |
First Address | Carmel, IN 46032-8708 |
Second Address | Carmel, IN 46032-8708 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/10/2016 |
Last Update Date | 12/10/2016 |