| NPI | 1053990531 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SALLY G PRIMUS Owner, Provider 317-400-3814 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0132X Clinic/Center, Ophthalmologic Surgery |
| Enumeration Date | 2021-04-03 |
| Last Update Date | 2023-05-26 |