| NPI | 1609323708 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARLA V CORK Physician/Owner 317-501-0210 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: IN 02003708A) |
| Enumeration Date | 2016-09-06 |
| Last Update Date | 2016-09-06 |