| NPI | 1366699431 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARAH MARIE GIBBS Office Manager 765-966-7668 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 02000324A) |
| Enumeration Date | 2008-08-20 |
| Last Update Date | 2015-02-09 |