Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath |
NPI | 1124629704 |
---|---|
Provider Name | Dr. Allison Durham |
First Address | Griffith, IN 46319-3122 |
Second Address | Griffith, IN 46319-3122 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/11/2020 |
Last Update Date | 02/11/2020 |