| NPI | 1922296185 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEITH GINGERICH President/Owner 219-462-7173 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: IN 01038826) |
| Enumeration Date | 2007-10-11 |
| Last Update Date | 2021-03-19 |