| NPI | 1013216894 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERENCE PADRIQUE Administrator 260-580-1350 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225400000X Rehabilitation Practitioner (Licence: IN 05008247A) |
| Enumeration Date | 2011-03-20 |
| Last Update Date | 2011-03-20 |