| NPI | 1346439239 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THELMA LYNETTE GREEN-MACK President 317-920-3220 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: IN 01037601B) |
| Enumeration Date | 2007-10-17 |
| Last Update Date | 2023-02-22 |