| NPI | 1275722886 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBRA A MEDEIROS Office Manager 317-925-6553 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: IN 0200649B) |
| Enumeration Date | 2007-10-19 |
| Last Update Date | 2007-10-25 |