| NPI | 1629280813 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHYLLIS M. WATKINS Billing Department 765-428-8888 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: IN 01057576A) |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2014-06-27 |