NPI | 1609417682 |
---|---|
Entity Type | Organization |
Authorized Contact | CHERYL ANNETTE WATHEN CFO 812-450-3296 |
Organization Subpart ? | No |
Primary Taxonomy | 213E00000X Podiatrist |
Additional Taxonomies | 207RN0300X Internal Medicine, Nephrology |
363A00000X Physician Assistant | |
363L00000X Nurse Practitioner | |
Enumeration Date | 2019-10-01 |
Last Update Date | 2019-10-01 |