| NPI | 1386252757 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER RUCCI Owner 260-483-9081 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2020-07-21 |
| Last Update Date | 2024-05-06 |