| NPI | 1669941514 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOEY VANDEVER CEO 317-892-8180 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer |
| Enumeration Date | 2018-11-21 |
| Last Update Date | 2020-12-15 |