| NPI | 1801378088 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY MCCOMIS President 219-836-1060 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery |
| 332900000X Non-Pharmacy Dispensing Site | |
| Enumeration Date | 2018-09-04 |
| Last Update Date | 2023-07-19 |