NPI | 1578561890 |
---|---|
Entity Type | Organization |
Authorized Contact | LUCAS M DRAKE Medical Director 317-865-2955 |
Organization Subpart ? | No |
Primary Taxonomy | 261QE0800X Clinic/Center, Endoscopy (Licence: IN 05-008858-1) |
Additional Taxonomies | 261QA1903X Clinic/Center, Ambulatory Surgical |
Enumeration Date | 2005-07-11 |
Last Update Date | 2024-09-23 |