| NPI | 1346119831 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY L COOPER Authorized Official 219-365-6560 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Enumeration Date | 2025-11-03 |
| Last Update Date | 2025-11-03 |