| NPI | 1093194805 | 
|---|---|
| Doing Business As | LOCAL 440 CLINIC | 
| Entity Type | Organization | 
| Authorized Contact | KARLA SPIVEY Central Support Specialist 317-869-3164 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care | 
| Enumeration Date | 2015-05-26 | 
| Last Update Date | 2024-06-27 |