| NPI | 1225262702 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DORIS WALKER JONES Chief Operational Manager 317-924-2824 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: IN 20042020A) |
| Enumeration Date | 2009-05-12 |
| Last Update Date | 2009-05-12 |