| NPI | 1063422137 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICTOR P MORAN CEO 765-284-7738 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery |
| Additional Taxonomies | 207L00000X Anesthesiology |
| 207QS0010X Family Medicine Sports Medicine | |
| 207RS0010X Internal Medicine Sports Medicine | |
| 207T00000X Neurological Surgery | |
| 207XS0106X Orthopaedic Surgery Hand Surgery | |
| 207XS0114X Orthopaedic Surgery Adult Reconstructive Orthopaedic Surgery | |
| 207XS0117X Orthopaedic Surgery Orthopaedic Surgery of the Spine | |
| 207XX0004X Orthopaedic Surgery Foot and Ankle Surgery | |
| 207XX0005X Orthopaedic Surgery Sports Medicine | |
| 208100000X Physical Medicine & Rehabilitation | |
| 213E00000X Podiatrist | |
| 225100000X Physical Therapist | |
| 225200000X Physical Therapy Assistant | |
| 225X00000X Occupational Therapist | |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2024-12-06 |