| NPI | 1801856349 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAYMOND KUSISTO CEO 260-484-8551 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: IN 50001907A) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: IN 50001907A) |
| 207L00000X Anesthesiology (Licence: IN 50001907A) | |
| 208100000X Physical Medicine & Rehabilitation (Licence: IN 50001907) | |
| Enumeration Date | 2006-03-27 |
| Last Update Date | 2025-09-11 |