| NPI | 1164146072 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA JOY DECH Fnp/Owner 219-728-6562 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2022-10-04 |
| Last Update Date | 2022-10-04 |