| NPI | 1215285523 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAYMOND CORTES VILLANUEVA Managing Member 317-755-1773 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: IN 05007709A) |
| Enumeration Date | 2012-08-16 |
| Last Update Date | 2012-08-16 |