| NPI | 1982240917 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID DUNHAM Owner 765-557-8569 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 225100000X Physical Therapist |
| 291U00000X Clinical Medical Laboratory | |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| 363L00000X Nurse Practitioner | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine | |
| Enumeration Date | 2019-11-25 |
| Last Update Date | 2022-07-12 |