| NPI | 1124342407 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY A QUIN Owner 765-472-3944 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: IN 01045818) |
| Enumeration Date | 2010-03-16 |
| Last Update Date | 2013-11-19 |