| Provider / Organization | NPI | Date Certified |
|---|---|---|
| ABALA KOMA TASSIKE | 1215665450 | 2022-08-14 |
Abala Koma Tassike is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1215665450. Registration indicates Abala Koma Tassike is a provider of services with a specialization in Other Service Providers, Driver (Driver, ) (Driver, Other Service Providers)
| Entity Type | Individual |
| Provider Name | Abala Koma Tassike |
| Practice Office Address | 5455 W 86TH ST STE 155 INDIANAPOLIS, IN US |
| Practice Office Telephone | 3096442037 |
| Mailing Address | 5455 W 86TH ST STE 155 INDIANAPOLIS, IN 462681540 US |
| Business Telephone | 3096442037 |
| phone [] | 3096442037 | Direct |
| Code | Practice | License No State |
|---|---|---|
| 172A00000X PRIMARY | Other Service Providers Driver Driver Driver Other Service Providers |