NPI 1033497979

Lord- Re- an S Vismanos

Practitioner Contractor Indianapolis, IN

Practice location

Address: 5980 W 71st St STE 102, Indianapolis, IN 46278-1785
Phone: (317) 388-0800
Fax: (317) 388-0805

Registered specialties

Contractor Primary

Other Service Providers Taxonomy 171W00000X Licence 9182 (AZ)

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Registry record

NPI: 1033497979
Entity type: Individual
Sex (as registered): Male
NPI issued: 26 Jul 2011
Record last updated: 26 Jul 2011

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.