Organization · Type 2 NPI

Premise Health of Indiana Medical, P.c.

Multi-Specialty Clinic/Center · Columbus, IN

NPI number 1417603879 Active

Practice location

1900 Mckinley Ave # 50060
Columbus, IN 47201-6414

Call (812) 377-4782 Map

Fax (812) 721-0283

Mailing address

5500 Maryland Way Ste 120
Brentwood, TN 37027-4993

Specialties and licenses

Taxonomy	Code	License
Multi-Specialty Clinic/Center Primary	261QM1300X	None listed

Multi-Specialty Clinic/Center: Definition to come...

NPI record

NPI: 1417603879
Entity type: Organization (Type 2)
Issued: Feb 24, 2022
Last updated: Aug 25, 2022
Status: Active

Other names

<unavail>
CTC Health & Wellness Center · doing business as
CTC Health & Wellness Center · doing business as

Authorized official

Jon Leizman
President
(216) 479-9063

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1417603879

Premise Health of Indiana Medical, P.c.'s National Provider Identifier is 1417603879, issued on Feb 24, 2022. The primary taxonomy on file is Multi-Specialty Clinic/Center (261QM1300X), and the practice location is in Columbus, IN. The record was last updated on Aug 25, 2022.