| NPI | 1104360338 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROGER WALTER LAROSE Audiologist 219-243-8077 |
| Organization Subpart ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: IL 147.000224) |
| Enumeration Date | 2016-12-07 |
| Last Update Date | 2016-12-07 |