| NPI | 1083213607 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HUBERT REYES Owner 812-270-9903 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2020-10-23 |
| Last Update Date | 2021-06-29 |