| NPI | 1487852943 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS J MELHAM Owner 765-287-8596 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: IN 01039790A) |
| Enumeration Date | 2007-07-06 |
| Last Update Date | 2020-08-22 |