| NPI | 1457530149 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOUGLAS P. WYNEKEN President/Secretary 317-797-4797 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: IN 05006312a) |
| Enumeration Date | 2007-10-30 |
| Last Update Date | 2007-10-30 |