| NPI | 1568777985 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COLLEEN HOOVER Billing 317-718-0044 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 01029733) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: IN 334000083A) |
| Enumeration Date | 2010-08-10 |
| Last Update Date | 2010-12-07 |