| NPI | 1790966331 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT L BRUNK Owner 219-465-4118 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: IN 02001839a) |
| Enumeration Date | 2007-11-26 |
| Last Update Date | 2014-09-04 |