| NPI | 1043353907 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN JOHN MASSICOTTE President 317-280-8410 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: IN 01039382A) |
| Enumeration Date | 2007-02-14 |
| Last Update Date | 2014-07-26 |