| NPI | 1235303165 |
|---|---|
| Other Name | PRIMARY CARE AT MISHAWAKA |
| Other Name | EDISON LAKES UROLOGY |
| Entity Type | Organization |
| Authorized Contact | TIMOTHY PORSCHE Managing Partner 574-296-3200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2008-04-22 |
| Last Update Date | 2020-07-15 |