| NPI | 1689751976 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARL WILLIAM WOOLDRIDGE President/Owner 765-962-5574 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: IN 06-004082-2) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2020-08-22 |