| NPI | 1366871832 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM SCOTT NALL Member 317-491-5272 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: IN 02003238A) |
| Additional Taxonomies | 207QS0010X Family Medicine, Sports Medicine (Licence: IN 02003238A) |
| Enumeration Date | 2013-11-05 |
| Last Update Date | 2021-10-22 |