| NPI | 1245213263 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH D. FORTIN Physician/Owner 260-459-7313 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation |
| Additional Taxonomies | 208VP0014X Pain Medicine Interventional Pain Medicine |
| 2251X0800X Physical Therapist Orthopedic | |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| 363A00000X Physician Assistant | |
| 363AM0700X Physician Assistant Medical (Licence: IN 10001306A) | |
| Enumeration Date | 2005-11-23 |
| Last Update Date | 2022-06-29 |