NPI | 1619155926 |
---|---|
Entity Type | Organization |
Authorized Contact | ALBERT WILLARDO Owner/Physician 219-845-2030 |
Organization Subpart ? | No |
Primary Taxonomy | 208D00000X General Practice (Licence: IN 01020554) |
Enumeration Date | 2008-02-08 |
Last Update Date | 2008-02-08 |