| NPI | 1134564404 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COLUMBUS O MBACHU President 219-769-6037 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center Physical Therapy (Licence: IN 05004975A) |
| Enumeration Date | 2013-05-01 |
| Last Update Date | 2013-11-23 |