| NPI | 1275692675 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHLEEN J GRUNDMAN Business Manager 812-882-3312 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: IN 07000497) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: IL 016003243) |
| Enumeration Date | 2006-12-08 |
| Last Update Date | 2008-09-11 |