| NPI | 1679515852 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH VICTOR WESTROM Owner 765-459-4070 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 01026400A) |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2007-10-11 |