| NPI | 1831423284 |
|---|---|
| Doing Business As | EDISON LAKES UROLOGY |
| Entity Type | Organization |
| Authorized Contact | KEVIN R BOYER Chief Executive Officer 574-296-3200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty |
| Enumeration Date | 2009-10-01 |
| Last Update Date | 2014-05-09 |