| NPI | 1497863120 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRUCE D IPPEL Owner 765-836-4874 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 01026974) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IN 71001495A) |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2008-02-28 |