| 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 |