| NPI | 1821281973 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY J KELLY Owner 317-621-7390 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RA0401X Internal Medicine, Addiction Medicine (Licence: IN 01028972) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IN 01028972) |
| Enumeration Date | 2007-08-22 |
| Last Update Date | 2014-06-11 |