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Organization

IMA EAST PRIMARY CARE

Active
Parent organization
IMA, INC.
Organization subpart
Yes

Provider details

NPI number
Legal business name
IMA, INC.
Authorized official
WESLEY W RATLIF M.D. (PRESIDENT)
(812) 331-3400
Entity
Organization

Contact information

Practice address
2605 E CREEKS EDGE DR, BLOOMINGTON, IN 47401-8368
(812) 355-2300
(812) 355-3251
Mailing address
550 S LANDMARK AVE, BLOOMINGTON, IN 47403-3239
(812) 355-6900
(812) 355-3251

Taxonomy

Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
01066805A
IN

Other

Enumeration date
08/06/2009
Last updated
01/14/2010
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