| NPI | 1457816613 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA DISMORE Assistant RN/ Health Educator 765-762-3035 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251K00000X Public Health or Welfare |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 208000000X Pediatrics | |
| Enumeration Date | 2019-02-01 |
| Last Update Date | 2019-02-01 |