| NPI | 1881871580 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN REX PARENT Owner 260-424-5656 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: IN 070053931) |
| Enumeration Date | 2008-01-24 |
| Last Update Date | 2008-02-22 |