| NPI | 1255796017 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHERI SARASIN Administrative Director 574-364-4733 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center Ambulatory Surgical |
| Enumeration Date | 2015-12-22 |
| Last Update Date | 2019-05-24 |