NPI | 1811343072 |
---|---|
Entity Type | Organization |
Authorized Contact | WILLIAM BLANCHARD Owner 317-518-8166 |
Organization Subpart ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209012388) |
Enumeration Date | 2016-05-06 |
Last Update Date | 2016-05-25 |