NPI | 1467634584 |
---|---|
Entity Type | Organization |
Authorized Contact | JERRY R POWELL President 765-675-8733 |
Organization Subpart ? | No |
Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: IN 01053633) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 01053633) |
Enumeration Date | 2007-11-30 |
Last Update Date | 2008-08-27 |