| NPI | 1518408343 |
|---|---|
| Doing Business As | LICE CLINICS OF AMERICA FT. WAYNE |
| Entity Type | Organization |
| Authorized Contact | MICHELE BUNDRANT Partner 317-345-0511 |
| Organization Subpart ? | No |
| Primary Taxonomy | 247200000X Technician, Other |
| Enumeration Date | 2017-03-13 |
| Last Update Date | 2017-03-13 |