| NPI | 1659448975 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA N BOOTH Physician Owner 260-463-4896 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 01041550A) |
| Enumeration Date | 2006-11-30 |
| Last Update Date | 2010-07-20 |