| NPI | 1023600178 |
|---|---|
| Doing Business As | CENTER GROVE WELLNESS CENTER |
| Entity Type | Organization |
| Authorized Contact | JEFFERY KIRKHAM AO 317-355-5822 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Enumeration Date | 2021-02-10 |
| Last Update Date | 2021-02-10 |