| NPI | 1437153285 |
|---|---|
| Former Legal Business Name | MIDWEST OTOLARNGOLOGY |
| Entity Type | Organization |
| Authorized Contact | MARK B LOGAN Owner 812-473-2060 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology |
| Enumeration Date | 2005-06-09 |
| Last Update Date | 2024-04-12 |