| NPI | 1104452200 |
|---|---|
| Doing Business As | ALTERNATIVE SCREENING SITE |
| Entity Type | Organization |
| Authorized Contact | EDWARD KYLE BENNETT President & CEO 812-996-0507 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Enumeration Date | 2020-03-20 |
| Last Update Date | 2020-03-20 |