| NPI | 1740589860 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KYLE DEFUR President 317-338-7031 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207QS0010X Family Medicine Sports Medicine |
| 207R00000X Internal Medicine | |
| 207RS0010X Internal Medicine Sports Medicine | |
| Enumeration Date | 2011-03-16 |
| Last Update Date | 2013-09-05 |