| NPI | 1902134521 |
|---|---|
| Doing Business As | MEMORIAL'S PRENATAL CLINIC @ OLIVE STREET |
| Entity Type | Organization |
| Authorized Contact | JEFFREY P. COSTELLO VP/CFO 574-647-3549 |
| Organization Subpart ? | No |
| Primary Taxonomy | 367A00000X Advanced Practice Midwife (Licence: IN 09000186A) |
| Enumeration Date | 2009-11-19 |
| Last Update Date | 2016-03-09 |