NPI | 1821390709 |
---|---|
Doing Business As | INTERNATIONAL COMMUNITY CLINIC |
Entity Type | Organization |
Authorized Contact | EROMONSELE O. IDAHOSA Medical Director 317-602-3558 |
Organization Subpart ? | No |
Primary Taxonomy | 261Q00000X Clinic/Center (Licence: IN 01057350A) |
Enumeration Date | 2010-11-25 |
Last Update Date | 2010-11-25 |