| NPI | 1346413614 |
|---|---|
| Doing Business As | SOUTHSIDE FAMILY PRACTICE |
| Entity Type | Organization |
| Authorized Contact | MARTHA K MILLER Director Of Billing 765-446-5286 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Enumeration Date | 2008-04-08 |
| Last Update Date | 2008-04-08 |