| NPI | 1003406000 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REUBEN C RUTLAND Chief Operation Officer 574-276-7184 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2021-01-22 |
| Last Update Date | 2021-06-28 |