| NPI | 1104157064 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN MYBECK Director Of Managed Care 219-392-7064 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QX0100X Clinic/Center, Occupational Medicine |
| Enumeration Date | 2010-01-15 |
| Last Update Date | 2024-07-11 |