| NPI | 1235320649 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HOLLY PATRICE WYSS Owner 317-887-2610 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: IN 71001532A) |
| Enumeration Date | 2007-08-09 |
| Last Update Date | 2007-10-18 |