| NPI | 1255516399 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEREK T MURPHY Owner/ Authorized Representative 765-425-9709 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: IN 02002983A) |
| Enumeration Date | 2008-01-08 |
| Last Update Date | 2008-01-08 |