| NPI | 1144217928 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENDA R STALLCOP Manager 812-232-8325 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: IN 008661) |
| Enumeration Date | 2005-10-05 |
| Last Update Date | 2020-08-22 |