| NPI | 1528300670 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORRIE S THIEL Billing Specialist 219-661-1592 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: IN 01026277) |
| Enumeration Date | 2013-03-26 |
| Last Update Date | 2013-03-26 |