| NPI | 1699003400 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES WALLACE ZOLLMAN Owner 317-328-1100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: IN 01023513B) |
| Enumeration Date | 2009-12-07 |
| Last Update Date | 2009-12-07 |