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 |