| NPI | 1700656022 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAWN MARIE MAHAFFEY Nurse Practitioner 574-281-0202 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2024-01-08 |
| Last Update Date | 2025-02-15 |