| NPI | 1134111594 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRUCE CARLTON BRINK President Of The Corp 812-386-7522 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 50003963A) |
| Enumeration Date | 2005-08-22 |
| Last Update Date | 2013-02-25 |