NPI | 1962645861 |
---|---|
Entity Type | Organization |
Authorized Contact | CLARENCE B AMAYUN President 765-453-8001 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: IN 01041643) |
Enumeration Date | 2009-04-08 |
Last Update Date | 2009-04-27 |