| NPI | 1043450208 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRY L SHIPE Owner 260-665-7595 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 01029019) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IN 01029019) |
| Enumeration Date | 2009-03-02 |
| Last Update Date | 2009-03-02 |