| NPI | 1639331556 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH MICHAEL KUNZER Dc 317-842-1188 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: IN 08001184) |
| Additional Taxonomies | 305R00000X Preferred Provider Organization (Licence: IN 0800184) |
| Enumeration Date | 2008-07-01 |
| Last Update Date | 2013-04-01 |