| NPI | 1255415790 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARRY LYNN EPPLEY Incorporator 317-814-4100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: IN 01038976A) |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2020-08-22 |