| NPI | 1477036671 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN STEPHAN MCGLOTHAN Managing Member/Medical Director 317-267-9014 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0132X Clinic/Center, Ophthalmologic Surgery |
| Enumeration Date | 2018-09-13 |
| Last Update Date | 2019-06-13 |