| NPI | 1689484875 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BENJAMIN FARTHING CEO 317-764-2141 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| 207N00000X Dermatology | |
| Enumeration Date | 2025-01-09 |
| Last Update Date | 2025-09-03 |