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1306044003
KIRK JON BODACH
SOUTH BEND, IN
NPI
1306044003
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207Q00000X Family Medicine
(Licence: IN 01065817A)
Enumeration Date
2007-07-05
Last Update Date
2021-03-30
Business Address
KIRK JON BODACH MD
615 N MICHIGAN ST FL 1
SOUTH BEND, IN 46601-1033
Phone number: 574-647-3050
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Mailing Address
KIRK JON BODACH MD
710 N NILES AVE
SOUTH BEND, IN 46617-1924
Phone number: 574-647-1610
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