| NPI | 1053712570 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOAN M VAUGHAN Hipaa Privacy Officer 765-496-1927 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2251X0800X Physical Therapist Orthopedic |
| Additional Taxonomies | 207RS0010X Internal Medicine Sports Medicine |
| 2255A2300X Specialist/Technologist Athletic Trainer | |
| Enumeration Date | 2014-09-16 |
| Last Update Date | 2014-10-24 |