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 |