| NPI | 1578833927 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZABETH MARY BODLE President 317-439-5924 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 9266707) |
| Enumeration Date | 2012-01-03 |
| Last Update Date | 2012-01-03 |