| NPI | 1184263352 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICK CRIST Sole Member 317-442-8436 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery |
| Additional Taxonomies | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2020-01-05 |
| Last Update Date | 2020-01-05 |