| NPI | 1194489757 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERICA WEHRMEISTER Officer/Authorized Official 260-760-9420 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2021-10-28 |
| Last Update Date | 2025-08-06 |