| Pure Life Injury Llc | |
|
4725 Statesmen Dr Ste B Indianapolis IN 46250-5645 | |
| (480) 566-9755 | |
| Not Available |
| Full Name | Pure Life Injury Llc |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 4725 Statesmen Dr Ste B, Indianapolis, Indiana |
| Authorized Official Name and Position | Shawn Vigneau (SOLE MEMBER) |
| Authorized Official Contact | 4802909899 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pure Life Injury Llc 4725 Statesmen Dr Ste B Indianapolis IN 46250-5645 Ph: () - | Pure Life Injury Llc 4725 Statesmen Dr Ste B Indianapolis IN 46250-5645 Ph: (480) 566-9755 |
| NPI Number | 1609344969 |
|---|---|
| Provider Enumeration Date | 11/05/2018 |
| Last Update Date | 11/05/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609344969 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
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