| NPI | 1427641042 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RACHELLE LYNN KILLION Business Office Manager 317-569-0033 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center Ambulatory Surgical |
| Enumeration Date | 2021-02-15 |
| Last Update Date | 2024-11-15 |