| NPI | 1033426580 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARRIE STRAW Billing 812-758-4034 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: IN 1055762a) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2010-09-04 |
| Last Update Date | 2016-04-22 |