| NPI | LastName | FirstName | MidName | Organization | Mailing Address | City | State | Zip |
| 1558381616 | BROEKHUIZEN | DANIEL | A | 6626 E. 75TH STREET | INDIANAPOLIS | IN | 462502890 | |
| 1083634141 | FOUTS | JENNIFER | J | 6626 E. 75TH STREET | INDIANAPOLIS | IN | 462502890 | |
| 1528202413 | MCHERRON | TONY | ISIAH | 6626 E 75TH ST | INDIANAPOLIS | IN | 462502890 |