| NPI | 1205801461 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH M SMITH Medical Director 765-939-1351 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: IN 05-010267-1) |
| Enumeration Date | 2006-02-21 |
| Last Update Date | 2020-08-22 |