| NPI | 1124440771 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | UJWALA PURANIK Administrator 219-476-7246 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: IN 1063580A) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology |
| 2085R0204X Radiology, Vascular & Interventional Radiology | |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2014-01-16 |
| Last Update Date | 2021-02-11 |