| NPI | 1982155487 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PETER DONALD FARR Owner 317-559-7970 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2016-10-19 |
| Last Update Date | 2020-01-07 |