| NPI | 1407519416 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANI EVANS Owner 317-667-2035 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer |
| Additional Taxonomies | 225400000X Rehabilitation Practitioner |
| Enumeration Date | 2021-10-17 |
| Last Update Date | 2021-10-17 |