| NPI | 1528000395 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACEY SHORTER Executive Director 574-946-6196 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 01021407A) |
| Enumeration Date | 2006-06-13 |
| Last Update Date | 2011-01-27 |