| NPI | 1881078202 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTHONY JAVORKA COO 317-621-1591 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213E00000X Podiatrist |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery |
| 213ES0000X Podiatrist Sports Medicine | |
| Enumeration Date | 2015-07-15 |
| Last Update Date | 2016-09-30 |