| NPI | 1053709402 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHEILA C FALLOON President/Owner 260-494-5884 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 01043979A) |
| Enumeration Date | 2015-01-07 |
| Last Update Date | 2015-03-17 |