| NPI | 1164616231 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARRY DWAYNE LOVALL Physician 317-718-5523 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 01025398) |
| Enumeration Date | 2007-08-31 |
| Last Update Date | 2026-01-08 |