| NPI | 1831399278 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICK CLIFFORD LOGAN President/Owner 317-359-5357 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: IN 01020481A) |
| Enumeration Date | 2007-07-24 |
| Last Update Date | 2007-07-24 |