| NPI | 1619114097 |
|---|---|
| Doing Business As | OLD SCHOOLHOUSE PEDIATRICS |
| Entity Type | Organization |
| Authorized Contact | MARJORIE E LAKE CEO/Owner 317-893-2364 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics |
| Enumeration Date | 2009-01-07 |
| Last Update Date | 2013-03-26 |