| NPI | 1639353949 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID MARK STINSON President/Provider 765-646-8479 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 01032850) |
| Enumeration Date | 2007-12-21 |
| Last Update Date | 2008-04-03 |