| NPI | 1023235793 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FELIX OLUSEGUN ODUSAGA President 219-689-3390 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IN 05005317A) |
| Enumeration Date | 2007-04-20 |
| Last Update Date | 2020-08-22 |