Individual provider · Type 1 NPI

Austin Ly

Student in an Organized Health Care Education/Training Program · Mishawaka, IN

NPI number 1265248991 Active

Practice location

611 E Douglas Rd Ste 407
Mishawaka, IN 46545-1468

Call (574) 335-6500 Map

Mailing address

1669 Riverside Dr Apt B
South Bend, IN 46616-1637

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1265248991

Austin Ly's National Provider Identifier is 1265248991, issued on Dec 7, 2024. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Mishawaka, IN. The record was last updated on May 28, 2025.