| NPI | 1902117146 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON CHAD Physician 317-818-1096 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IN 01060267A) |
| Enumeration Date | 2010-06-22 |
| Last Update Date | 2010-07-07 |