| NPI | 1811019847 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORI R. COLLINS Billing Office Manager 317-278-7019 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: IN 50002895A) |
| Enumeration Date | 2007-04-03 |
| Last Update Date | 2020-08-22 |