| NPI | 1922639673 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRADLEY G. ORRIS Md 317-859-7222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies Customized Equipment |
| Enumeration Date | 2020-01-31 |
| Last Update Date | 2021-07-14 |