| NPI | 1598804064 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHERI L HIRST Administrator 765-284-0134 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: IN 010353) |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2020-08-22 |