| NPI | 1710023510 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLESINE H. FORD Nurse Practitioner 317-925-6747 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251K00000X Public Health or Welfare (Licence: IN 28136803A) |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2020-08-22 |