| NPI | 1710924089 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN BEAVERSON Director 317-574-5400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center Ambulatory Surgical (Licence: IN 15-007125-1) |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2025-04-08 |