| NPI | 1619343019 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENDELL LYNN OETTER Physician 219-789-6704 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 02001332A) |
| Enumeration Date | 2015-08-19 |
| Last Update Date | 2015-08-19 |