| NPI | 1891907903 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONNIE K TAYLOR President 317-508-5937 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: IN 200081940) |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2008-02-20 |