| NPI | 1801243688 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACOB LAWRENCE TUTTLE President 574-314-6436 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: IN 01072927A) |
| Enumeration Date | 2016-05-20 |
| Last Update Date | 2016-08-26 |