| NPI | 1134518053 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOUGLAS J VAN PUTTEN Owner/CEO 219-464-7546 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: IN 01039408A) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: IN 01039408A) |
| Enumeration Date | 2015-01-15 |
| Last Update Date | 2015-03-25 |