| NPI | 1629371117 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL A SPITE President 574-514-1785 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: IN 01040540A) |
| Additional Taxonomies | 171W00000X Contractor (Licence: IN 05008951A) |
| 363LF0000X Nurse Practitioner, Family (Licence: IN 71002234A) | |
| Enumeration Date | 2010-12-06 |
| Last Update Date | 2010-12-06 |