| NPI | 1457661662 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID G CRANE President 812-339-1221 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: IN 01019739) |
| Enumeration Date | 2010-10-21 |
| Last Update Date | 2010-10-21 |