| NPI | 1033392808 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINNIE JEAN ROGERS Ofc Mgn 765-675-7601 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: IN 01024399) |
| Enumeration Date | 2007-12-14 |
| Last Update Date | 2007-12-14 |