CORY BANASCHAK
Individual Provider (NPI-1)
Active
Surgery
Provider Information
- NPI Number
1306377874- Provider Type
- Individual Provider (NPI-1)
- Status
- Active
Contact & Location
- Address
- 2325 18TH ST STE 220, COLUMBUS, IN, 472015389
- Phone
- (812) 376-5640
Specialties & Taxonomies
Surgery
Primary License: IN #02006100A