| NPI | 1700187457 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFF P COSTELLO CFO 574-647-3549 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: IN 10-005017-1) |
| Enumeration Date | 2010-11-11 |
| Last Update Date | 2023-04-28 |