| NPI | 1578629242 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM L CARPENTER Board Manager 317-621-7475 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: MI 636931) |
| Enumeration Date | 2006-12-28 |
| Last Update Date | 2007-12-14 |