| NPI | 1891154076 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE HAMM Practice Manager 765-446-5111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: IN 01044990A) |
| Enumeration Date | 2016-02-17 |
| Last Update Date | 2016-02-17 |