| NPI | 1881432862 |
|---|---|
| Doing Business As | MARY RUTAN INDIAN LAKE CLINIC |
| Entity Type | Organization |
| Authorized Contact | THOMAS DENBOW VP Of Finance And Development 937-651-6688 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QR1300X Clinic/Center, Rural Health |
| Enumeration Date | 2024-07-16 |
| Last Update Date | 2024-07-16 |