| NPI | 1235661109 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLAUDIA JACKSON VP Of Finance 317-522-2054 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 213E00000X Podiatrist | |
| 231H00000X Audiologist | |
| 237600000X Audiologist-Hearing Aid Fitter | |
| 237700000X Hearing Instrument Specialist | |
| Enumeration Date | 2017-03-30 |
| Last Update Date | 2017-11-02 |