| NPI | 1609316215 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JERRY L CLARK Owner 812-234-9332 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251K00000X Public Health or Welfare (Licence: IN 17001164A) |
| Enumeration Date | 2017-03-01 |
| Last Update Date | 2017-03-01 |