| NPI | 1689282741 |
|---|---|
| Other Name | INDAE LLC |
| Entity Type | Organization |
| Authorized Contact | JEREMY BUCKNER Sole Owner 480-930-4018 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2020-07-15 |
| Last Update Date | 2020-07-15 |