| NPI | 1790506376 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNON PERRY Director Reimbursement 260-437-7558 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2024-10-17 |
| Last Update Date | 2025-07-30 |