Provider Information for 1093228686
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HALEY DARR
Sex: Female
NPI: 1093228686
Last Updated: 2024-04-09
Certification Date: 2024-04-09
Certification Date: 2024-04-09
Details
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NPI | 1093228686 | ||||||||
Enumeration Date | 2017-11-06 | ||||||||
NPI Type | NPI-1 Individual | ||||||||
Sole Proprietor | NO | ||||||||
Status | Active | ||||||||
Mailing Address | 11401 BLUEGRASS PKWY LOUISVILLE, KY 40299-2349 United States Phone: | Fax: | ||||||||
Primary Practice Address | 4410 EXECUTIVE BLVD FORT WAYNE, IN 46808-1135 United States Phone: 317-452-6279 | Fax: | ||||||||
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