| NPI | 1700161981 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMIA FISHER Credentialing Specialist 812-962-7894 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2011-10-19 |
| Last Update Date | 2019-10-07 |