NPI | 1104122159 |
---|---|
Entity Type | Organization |
Authorized Contact | DANIEL P DURAN Partner 317-392-6200 |
Organization Subpart ? | No |
Primary Taxonomy | 208D00000X General Practice (Licence: IN 01050761A) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: IN IN08001540A) |
207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: IN 01050761A) | |
Enumeration Date | 2011-02-08 |
Last Update Date | 2011-02-08 |