| NPI | 1154440675 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HOWARD CHRISTOPHER DEITSCH Physician 765-983-1328 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS1000X Clinic/Center, Student Health (Licence: IN 01025101) |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2020-08-22 |