| NPI | 1265667711 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY LYMAN SHAW President 317-852-3870 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111NX0800X Chiropractor Orthopedic (Licence: IN 08001024) |
| Additional Taxonomies | 111NS0005X Chiropractor Sports Physician (Licence: IN 08001024) |
| Enumeration Date | 2009-05-27 |
| Last Update Date | 2009-05-27 |