| NPI | 1407007933 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIVINA COLLEEN REYES Staff Nurse Practitioner 317-962-8880 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QE0002X Clinic/Center, Emergency Care (Licence: IN 71002749A) |
| Enumeration Date | 2008-10-02 |
| Last Update Date | 2008-10-02 |