| NPI | 1841393980 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DARRYL R. BUSBY Executive Administrator 574-296-3255 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center Ambulatory Surgical (Licence: IN 11-010807) |
| Enumeration Date | 2006-09-06 |
| Last Update Date | 2011-03-28 |