| NPI | 1114395647 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRANCE DRAKE Chief Medical Officer 317-576-1335 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: IN 28171905A) |
| Enumeration Date | 2015-09-15 |
| Last Update Date | 2015-09-15 |