| NPI | 1578574463 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHERRI A BIDWELL Business Office Manager 765-281-2188 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2015-01-06 |