| NPI | 1366492936 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JILL JOHNSON Administrator 219-872-7464 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: IN 50000203A) |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2011-09-06 |