| NPI | 1861692402 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IRENE ERICA ROGE President 317-697-6536 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213EP1101X Podiatrist, Primary Podiatric Medicine (Licence: IN 07001009A) |
| Additional Taxonomies | 213EP1101X Podiatrist, Primary Podiatric Medicine (Licence: IL 016-004848) |
| Enumeration Date | 2007-07-23 |
| Last Update Date | 2011-06-03 |