| NPI | 1700249059 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLAUDIA JACKSON Vice President Of Finance 317-522-2054 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: IN 07000570A) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2016-04-04 |
| Last Update Date | 2017-11-02 |