| NPI | 1073793816 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK H. RUNKLE President 317-859-2905 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP1100X Clinic/Center, Podiatric (Licence: IN 07000797) |
| Enumeration Date | 2007-11-09 |
| Last Update Date | 2021-12-21 |