| NPI | 1720108574 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN R WALLING President CEO 765-423-1604 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: IN 060109511) |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2020-08-22 |