| NPI | 1417173717 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRY W EBERT President 219-836-1050 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: IN 01022150A) |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2023-03-07 |