| NPI | 1730619057 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DUANE SNIDER Member 317-946-9929 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 111N00000X Chiropractor |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2017-06-19 |
| Last Update Date | 2022-07-21 |