| NPI | 1356183230 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID LUSHINSKY Manager 765-643-8781 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| 291U00000X Clinical Medical Laboratory | |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2024-06-11 |
| Last Update Date | 2024-06-11 |