| NPI | 1124372131 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANE ALLEN AVERY Chief Executive Officer 812-752-1151 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 01045558A) |
| Enumeration Date | 2012-10-30 |
| Last Update Date | 2013-04-05 |