| NPI | 1205955119 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARRY T. MICON President 317-923-7211 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist |
| Additional Taxonomies | 174400000X Specialist |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2012-09-18 |