| NPI | 1750682233 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN DOMINIC ROSCOE President 219-465-7277 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 01030427A) |
| Enumeration Date | 2010-11-15 |
| Last Update Date | 2010-11-15 |