| NPI | 1568881076 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY NEAL DEWESTER Owner / Physician 317-807-0247 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: IN 01036126A) |
| Enumeration Date | 2014-04-11 |
| Last Update Date | 2014-04-11 |