| NPI | 1760813422 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SVETLANA BUCCHINO Owner 765-289-1011 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: IN 01057078A) |
| Enumeration Date | 2013-12-06 |
| Last Update Date | 2013-12-06 |