| NPI | 1366786584 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONALD G SHEPPARD Owner 317-849-1222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: IN 71001227A) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: IN 08000647A) |
| 2086S0129X Surgery, Vascular Surgery (Licence: IN 71001227A) | |
| Enumeration Date | 2012-11-15 |
| Last Update Date | 2017-08-04 |