| NPI | 1902660863 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH DAVID DONADIO Vice President Of Operations 317-845-5974 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2024-02-12 |
| Last Update Date | 2024-02-12 |