| NPI | 1295962736 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID J. DUNHAM Owner/Director 317-253-1644 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IN 71002983A) |
| Additional Taxonomies | 111N00000X Chiropractor |
| 163W00000X Registered Nurse (Licence: IN 28195910A) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: IN 01043420A) | |
| 225100000X Physical Therapist (Licence: IN 05010034A) | |
| 291U00000X Clinical Medical Laboratory | |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2009-06-11 |
| Last Update Date | 2020-05-11 |