| NPI | 1679746143 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HEATHER DAWSON Director Of Billing 765-446-5417 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: IN 01023876A) |
| Additional Taxonomies | 208000000X Pediatrics |
| Enumeration Date | 2008-04-07 |
| Last Update Date | 2025-07-17 |