| NPI | 1497354526 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMAL LEONARD I.T. Coordinator 317-847-8836 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine |
| Enumeration Date | 2020-10-20 |
| Last Update Date | 2021-05-24 |