| NPI | 1356530992 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY A. WOLOSZYN Billing Manager 219-942-8518 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 01020846A) |
| Enumeration Date | 2007-10-19 |
| Last Update Date | 2007-10-19 |