| NPI | 1194580886 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRUCE PHILLIPS Clinic Director 812-346-4181 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2024-02-21 |
| Last Update Date | 2024-02-21 |