| NPI | 1306244231 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DRU NICHOLE BISHOP Credentialing Specialist 260-432-4700 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Enumeration Date | 2014-12-09 |
| Last Update Date | 2014-12-16 |