| NPI | 1497406110 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERICA WEHRMEISTER Authorized Official 260-760-9420 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2022-01-13 |
| Last Update Date | 2025-04-09 |