| NPI | 1265440390 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH WAYNE BLUMENTHAL President 219-531-5855 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: IN 02000639A) |
| Additional Taxonomies | 174400000X Specialist (Licence: IN 01049183A) |
| Enumeration Date | 2006-08-04 |
| Last Update Date | 2024-05-07 |