| NPI | 1083608327 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICKIE J BLAIR Credential COO Rdinator 260-436-8686 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: IN 50002482A) |
| Enumeration Date | 2005-09-01 |
| Last Update Date | 2020-08-22 |