| NPI | 1942563259 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN A DETTMER Owner 317-272-4100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor |
| Additional Taxonomies | 208D00000X General Practice |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2012-06-21 |
| Last Update Date | 2017-04-26 |