| NPI | 1750680963 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VONDA M LOVE CEO/President 317-450-6596 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: IN 71002018A) |
| Additional Taxonomies | 261QC1500X Clinic/Center, Community Health (Licence: IN 71002018A) |
| 261QX0100X Clinic/Center, Occupational Medicine (Licence: IN 71002018A) | |
| Enumeration Date | 2011-03-28 |
| Last Update Date | 2011-03-28 |