| NPI | 1790809788 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARTHA K MILLER Director Of Billing 765-446-5417 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2007-03-17 |
| Last Update Date | 2013-03-27 |