| NPI | 1831546225 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CATHERINE BAST Medical Director 574-537-2680 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 208D00000X General Practice | |
| 225700000X Massage Therapist | |
| Enumeration Date | 2016-05-16 |
| Last Update Date | 2019-09-09 |