| NPI | 1538349956 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS P VAN DEN DRIESSCHE Owner 260-424-3134 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 01028709A) |
| Enumeration Date | 2007-11-14 |
| Last Update Date | 2007-11-14 |