| NPI | 1013912286 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS VANDERGRIFT Chief Executive Administrator 574-296-3200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2005-06-15 |
| Last Update Date | 2024-05-21 |