| NPI | 1063611325 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAWN M SANGALANG Owner 317-898-5800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: IN 01017401A) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: IN 01017401A) |
| 111N00000X Chiropractor (Licence: IN 08001241A) | |
| Enumeration Date | 2007-07-16 |
| Last Update Date | 2013-03-13 |