| NPI | LastName | FirstName | MidName | Organization | Mailing Address | City | State | Zip |
| 1790090504 | FIZER | TED | C | 1155 W 3RD ST | BLOOMINGTON | IN | 474045016 | |
| 1932217858 | HEILMAN | STEVEN | J | PO BOX 4778 | BLOOMINGTON | IN | 474024778 | |
| 1164638631 | HOTTMAN | LANCE | MCLEAN | PO BOX 4778 | BLOOMINGTON | IN | 474024778 | |
| 1497990303 | JANTZEN | JENNIFER | PO BOX 4778 | BLOOMINGTON | IN | 474024778 | ||
| 1164610101 | SMITH | CHRISTOPHER | MATTHEW | PO BOX 4778 | BLOOMINGTON | IN | 474024778 |