| NPI | 1316994122 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM L CARPENTER Board Manager 317-621-7475 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center Ambulatory Surgical (Licence: MI 636818) |
| Enumeration Date | 2006-05-27 |
| Last Update Date | 2007-12-14 |